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. 2021 Mar;49(3):3000605211000519.
doi: 10.1177/03000605211000519.

Trauma and donation after circulatory death: a case series from a major trauma center

Alessandro Circelli  1 , Etrusca Brogi  2 , Emiliano Gamberini  1 , Emanuele Russo  1 , Marco Benni  1 , Giovanni Scognamiglio  1 , Andrea Nanni  1 , Federico Coccolini  3 , Francesco Forfori  2 , Paola Fugazzola  4 , Luca Ansaloni  4 , Piergiorgio Solli  5 , Fabrizio Di Benedetto  6 , Matteo Cescon  7 , Vanni Agnoletti  1
Affiliations

Trauma and donation after circulatory death: a case series from a major trauma center

Alessandro Circelli et al. J Int Med Res. 2021 Mar.

Abstract

Even with encouraging recipient outcomes, transplantation using donation after circulatory death (DCD) is still limited. A major barrier to this type of transplantation is the consequences of warm ischemia on graft survival; however, preservation techniques may reduce the consequences of cardiac arrest and provide better organ conservation. Furthermore, DCD in trauma patients could further expand organ donation. We present five cases in which organs were retrieved and transplanted successfully using normothermic regional perfusion (NRP) in trauma patients. Prompt critical care support and surgical treatment allowed us to overcome the acute phase. Unfortunately, owing to the severity of their injuries, all of the donors died. However, the advanced and continuous organ-specific supportive treatment allowed the maintenance of general clinical stability and organ preservation. Consequently, it was possible to retrieve and transplant the donors' organs. Death was ascertained in accordance with cardio-circulatory criteria, which was followed by NRP. We consider that DCD in trauma patients may represent an important source of organs.

Keywords: Organ donation; controlled donation after circulatory death; kidney transplantation; liver transplantation; lung transplantation; normothermic regional perfusion; trauma; trauma donors.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Extracorporeal membrane oxygenation (ECMO) treatment for the five cases in this series. a) Case 1: kidneys, lungs, and liver retrieved; total NRP time: 146 minutes; b) Case 2: kidneys, lungs, and liver retrieved; total NRP time: 72 minutes; c) Case 3: lungs and liver retrieved; total NRP time: 55 minutes; d) Case 4: kidneys retrieved; total NRP time: 200 minutes; e) Case 5: kidneys and liver retrieved; total NRP time: 158 minutes. RPM, revolutions per minute; mL per minute, blood flow on the extracorporeal membrane oxygenation (ECMO) machine; TIME, duration of normothermic regional perfusion (NRP).
See this image and copyright information in PMC

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