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Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation

Shortage of deceased donor organs for transplantation has led to the increased use of organs from donation after circulatory death (DCD) donors. There are currently no reports describing outcomes after multiorgan transplantation with DCD livers. The use of DCD organs for multiorgan transplantation c...

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Autores principales: van Leeuwen, Otto B., Brüggenwirth, Isabel M.A., de Kleine, Ruben H.J., van den Berg, Aad P., Verschuuren, Erik A.M., Erasmus, Michiel E., Porte, Robert J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384395/
https://www.ncbi.nlm.nih.gov/pubmed/34476297
http://dx.doi.org/10.1097/TXD.0000000000001165
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author van Leeuwen, Otto B.
Brüggenwirth, Isabel M.A.
de Kleine, Ruben H.J.
van den Berg, Aad P.
Verschuuren, Erik A.M.
Erasmus, Michiel E.
Porte, Robert J.
author_facet van Leeuwen, Otto B.
Brüggenwirth, Isabel M.A.
de Kleine, Ruben H.J.
van den Berg, Aad P.
Verschuuren, Erik A.M.
Erasmus, Michiel E.
Porte, Robert J.
author_sort van Leeuwen, Otto B.
collection PubMed
description Shortage of deceased donor organs for transplantation has led to the increased use of organs from donation after circulatory death (DCD) donors. There are currently no reports describing outcomes after multiorgan transplantation with DCD livers. The use of DCD organs for multiorgan transplantation can be enhanced if the detrimental effects of prolonged cold ischemia and subsequent ischemia-reperfusion injury are overcome. We present a case in which the liver and lungs of a DCD donor were preserved using ex situ machine perfusion for combined liver-lung transplantation. The recipient was a 19-year-old male patient requiring bilateral lung transplantation for severe progressive pleural parenchymal fibroelastosis and portal hypertension with portal vein thrombosis. The donor liver was preserved with dual hypothermic oxygenated machine perfusion, whereas the lungs were perfused using ex vivo lung perfusion. With ex vivo lung perfusion, total preservation time of right and left lung reached 17 and 21 h, respectively. Now, 2 y after transplantation, liver function is normal and lung function is improving. To conclude, we suggest that combined transplantation of DCD liver and lungs is feasible when cold ischemia is reduced with ex situ machine perfusion preservation.
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spelling pubmed-83843952021-09-01 Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation van Leeuwen, Otto B. Brüggenwirth, Isabel M.A. de Kleine, Ruben H.J. van den Berg, Aad P. Verschuuren, Erik A.M. Erasmus, Michiel E. Porte, Robert J. Transplant Direct Liver Transplantation Shortage of deceased donor organs for transplantation has led to the increased use of organs from donation after circulatory death (DCD) donors. There are currently no reports describing outcomes after multiorgan transplantation with DCD livers. The use of DCD organs for multiorgan transplantation can be enhanced if the detrimental effects of prolonged cold ischemia and subsequent ischemia-reperfusion injury are overcome. We present a case in which the liver and lungs of a DCD donor were preserved using ex situ machine perfusion for combined liver-lung transplantation. The recipient was a 19-year-old male patient requiring bilateral lung transplantation for severe progressive pleural parenchymal fibroelastosis and portal hypertension with portal vein thrombosis. The donor liver was preserved with dual hypothermic oxygenated machine perfusion, whereas the lungs were perfused using ex vivo lung perfusion. With ex vivo lung perfusion, total preservation time of right and left lung reached 17 and 21 h, respectively. Now, 2 y after transplantation, liver function is normal and lung function is improving. To conclude, we suggest that combined transplantation of DCD liver and lungs is feasible when cold ischemia is reduced with ex situ machine perfusion preservation. Lippincott Williams & Wilkins 2021-06-18 /pmc/articles/PMC8384395/ /pubmed/34476297 http://dx.doi.org/10.1097/TXD.0000000000001165 Text en Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Liver Transplantation
van Leeuwen, Otto B.
Brüggenwirth, Isabel M.A.
de Kleine, Ruben H.J.
van den Berg, Aad P.
Verschuuren, Erik A.M.
Erasmus, Michiel E.
Porte, Robert J.
Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation
title Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation
title_full Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation
title_fullStr Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation
title_full_unstemmed Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation
title_short Machine Perfusion of Donation After Circulatory Death Liver and Lungs Before Combined Liver-lung Transplantation
title_sort machine perfusion of donation after circulatory death liver and lungs before combined liver-lung transplantation
topic Liver Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384395/
https://www.ncbi.nlm.nih.gov/pubmed/34476297
http://dx.doi.org/10.1097/TXD.0000000000001165
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