Article
Immunology
Angela Kotsopoulos, Piet Vos, Marloes Witjes, Meint Volbeda, Hildegard Franke, Jelle Epker, Hans Sonneveld, Koen Simons, Ewald Bronkhorst, Ruud Mullers, Nichon Jansen, Hans van der Hoeven, Wilson F. Abdo
Summary: This study aimed to develop prediction models for circulatory death within 1 or 2 hours after withdrawal of life-sustaining treatment in controlled donation after circulatory death (cDCD) donors. The models were developed using LASSO regression and machine learning-artificial intelligence analysis, and their predictive ability was externally validated. The results showed that the models had a reasonable ability to predict circulatory death.
Article
Surgery
Jose Luis Campo-Canaveral de la Cruz, Eduardo Minambres, Elisabeth Coll, Maria Padilla, Gloria Sanchez Antolin, Gloria de la Rosa, Joel Rosado, Francisco Javier Gonzalez Garcia, Silvana Crowley Carrasco, Gabriel Sales Badia, Eva Maria Fieria Costa, Jose Alberto Garcia Salcedo, Victor Mora, Carlos de la Torre, Rafael Badenes, Lander Atutxa Bizkarguenaga, Beatriz Dominguez-Gil
Summary: This study aimed to investigate the outcomes of lung and liver transplantation using NRP in cDCD donors and compare them with transplants using DBD grafts. The results showed that simultaneous transplantation of lungs and livers from cDCD donors using NRP offers similar outcomes to transplants using DBD grafts.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Review
Immunology
Kimia Honarmand, Fayez Alshamsi, Farid Foroutan, Bram Rochwerg, Emilie Belley-Cote, Graham Mclure, Frederick D'Aragon, Ian M. Ball, Alp Sener, Markus Selzner, Gordon Guyatt, Maureen O. Meade
Summary: The use of heparin in donation after circulatory death varies widely, with uncertain effects on transplant outcomes. While there may be benefits in terms of reducing certain transplant complications, evidence certainty remains low.
Editorial Material
Anesthesiology
Christine Lennon, Dan Harvey, Peter A. Goldstein
Summary: Transplant surgery raises numerous ethical considerations, especially as medicine advances and challenges the boundaries of what is technically possible. This article examines the ethical implications of physician participation in procedures necessary for patient care, particularly focusing on organ donation after circulatory determination of death. Strategies to mitigate potential negative impact on the psychological well-being of the patient care team are also discussed.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Urology & Nephrology
Anna Buxeda, Gonzalo Velis, Carlos Arias-Cabrales, Ana Zapatero, Carla Burballa, Dolores Redondo-Pachon, Marisa Mir, Marta Crespo, Julio Pascual, Maria Jose Perez-Saez
Summary: A study compared outcomes of kidney transplant recipients from elderly controlled donation after circulatory death (cDCD) donors and elderly donation after brain death (DBD) donors, showing similar short- and medium-term graft survival but lower patient survival in elderly cDCD recipients, primarily influenced by recipient age.
CLINICAL KIDNEY JOURNAL
(2021)
Article
Surgery
Shuji Okahara, Gregory Snell, Mark McDonald, Rohit D'Costa, Helen Opdam, David Pilcher, Bronwyn Levvey
Summary: The use of DCD donors has increased lung transplant activity, but a significant percentage do not successfully convert to donation due to various factors. Factors like ICU stay length, brain damage severity, and vasopressin use are related to successful conversion to actual donation. CART modeling can help identify DCD donor candidates with low probability of progression.
TRANSPLANT INTERNATIONAL
(2021)
Article
Cardiac & Cardiovascular Systems
Shivank Madan, Omar Saeed, Stephen J. Forest, Daniel J. Goldstein, Ulrich P. Jorde, Snehal R. Patel
Summary: This study provides a preliminary analysis of adult donation after circulatory death heart transplantations (DCD-HTs) in the United States, showing favorable early outcomes and suggesting the potential for a substantial increase in adult heart transplant volumes with the use of DCD donors.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Article
Surgery
Jennie H. Kwon, Walker M. Blanding, Khaled Shorbaji, Joseph R. Scalea, Barry C. Gibney, Prabhakar K. Baliga, Arman Kilic
Summary: Organ donation after circulatory death (DCD) expands access to transplantation and improves waitlist outcomes for liver and heart transplant candidates. However, DCD transplant carries increased mortality risk for kidney, liver, and lung recipients.
Review
Immunology
Vasudev Pai, Ellie Asgari, Marius Berman, Chris Callaghan, Paul Corris, Stephen Large, Simon Messer, David Nasralla, Jas Parmar, Chris Watson, Stephen O'Neill
Summary: This manuscript summarizes the relevant recommendations from the British Transplantation Society's guideline on transplantation of cardiothoracic organs, aiming to address the challenge of maximizing organ utilization from donation after circulatory death (DCD) donors.
TRANSPLANTATION REVIEWS
(2023)
Article
Surgery
Maria Jose Perez-Saez, Javier Juega, Ana Zapatero, Jordi Comas, Jaume Tort, Ricardo Lauzurica, Julio Pascual
Summary: The number of kidney transplants using cDCD donors has increased in Spain, with comparable outcomes in elderly recipients between cDCD-KT and DBD-KT in terms of patient and graft survival. Factors such as previous cardiovascular disease and DGF were identified as independent risk factors for patient death, while donation type (cDCD vs. DBD) did not significantly impact patient survival or graft loss.
TRANSPLANT INTERNATIONAL
(2021)
Review
Transplantation
Chetan Pasrija, Yuliya Tipograf, Ashish S. Shah, John M. Trahanas
Summary: This review provides an update on normothermic regional perfusion (NRP) and its logistics, technique, outcomes, as well as ethical issues. There is renewed interest in using NRP to improve the quality and availability of organs from donation after circulatory death (DCD) donors. Evidence suggests that NRP can be conducted in a practical and cost-efficient manner, with better organ yield compared to standard direct procurement and perfusion (DPP). However, the ethical debate surrounding NRP, particularly thoraco-abdominal NRP (TA-NRP), needs to be resolved before wider acceptance.
CURRENT OPINION IN ORGAN TRANSPLANTATION
(2023)
Review
Urology & Nephrology
Wai H. Lim, Beatriz Dominguez-Gil
Summary: With the increasing demand for kidney transplants and the inadequate supply of organs, donation after the circulatory determination of death (DCDD) has become an important global source of kidneys for transplantation. The outcomes of both controlled and uncontrolled DCDD kidney transplants have been shown to be favorable, although uncontrolled DCDD transplants carry a higher risk of primary nonfunction. However, the potential of DCDD remains untapped in many countries due to ethical concerns and resource implications.
SEMINARS IN NEPHROLOGY
(2022)
Review
Ethics
Nicholas Murphy, Charles Weijer, Maxwell Smith, Jennifer Chandler, Erika Chamberlain, Teneille Gofton, Marat Slessarev
Summary: cDCDD is an important strategy for increasing the pool of eligible organ donors by determining organ donation after circulatory death.
JOURNAL OF LAW MEDICINE & ETHICS
(2021)
Article
Urology & Nephrology
Argiris Asderakis, Tarique K. Sabah, William J. Watkins, Usman Khalid, Laszlo Szabo, Michael R. Stephens, Sian Griffin, Rafael Chavez
Summary: This study evaluated the effects of different induction immunosuppression agents on the outcome of kidney transplants from donors after circulatory death (DCD). The results suggest that thymoglobulin induction may provide better patient survival compared to alemtuzumab, while having similar advantage in terms of acute rejection.
KIDNEY INTERNATIONAL REPORTS
(2022)
Article
Engineering, Biomedical
Stefano Baroni, Andrea Marudi, Simone Rinaldi, Silvia Ghedini, Paolo Magistri, Gian Piero Guerrini, Tiziana Olivieri, Chiara Dallai, Marta Talamonti, Jessica Maccieri, Fabrizio Di Benedetto, Elisabetta Bertellini
Summary: This paper describes a case series of DCD donors of liver and kidneys, investigating the changes in inflammatory cytokine levels before and after hemadsorption during normothermic reperfusion. It was observed that hemadsorption led to a reduction in IL-10 and TNF-alpha levels, and successful transplantation of all organs was achieved without significant complications.
INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS
(2022)
