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. 2024 Jan 1;108(1):192-197.
doi: 10.1097/TP.0000000000004669. Epub 2023 Dec 13.

Simultaneous Lung-abdominal Organ Procurement From Donation After Circulatory Death Donors Reduces Donor Hepatectomy Time

Joris Blondeel  1   2 , Maarten Blondeel  2 , Nicholas Gilbo  1   2 , Christelle M Vandervelde  3   4 , Steffen Fieuws  5 , Ina Jochmans  1   2 , Dirk Van Raemdonck  3   4 , Jacques Pirenne  1   2 , Laurens J Ceulemans  3   4 , Diethard Monbaliu  1   2
Affiliations

Simultaneous Lung-abdominal Organ Procurement From Donation After Circulatory Death Donors Reduces Donor Hepatectomy Time

Joris Blondeel et al. Transplantation. .

Abstract

Background: Prolonged organ procurement time impairs the outcome of donation after circulatory death (DCD) and liver transplantation (LiT). Our transplant team developed a simultaneous, rather than sequential, lung-abdominal organ explantation strategy for DCD donation to prioritize liver procurement. We evaluated whether this change in strategy effectively reduced donor hepatectomy time (dHT), without affecting donor pneumonectomy time (dPT), and influenced LiT and lung transplantation outcome.

Methods: All lung-abdominal and abdominal-only transplant procedures between 2010 and 2020 were analyzed in this retrospective cohort study. Relationships were assessed between the year of transplant and dHT and dPT (univariate linear regression), 1-y patient and graft survival, primary graft dysfunction, and nonanastomotic biliary strictures (univariate logistic regression).

Results: Fifty-two lung-abdominal and 110 abdominal-only DCD procedures were analyzed. A significant decrease in dHT was noted in lung-abdominal (slope -1.14 [-2.14; -0.15], P = 0.026) but not in abdominal-only procedures; dPT did not increase. There were no significant associations between the year of transplant and nonanastomotic biliary strictures frequency, primary graft dysfunction incidence, 1-y patient, and graft survival.

Conclusions: Simultaneous organ procurement in multiorgan lung-abdominal DCD procedures is feasible, and effectively shortened dHT without affecting lung transplantation outcome. No impact on LiT outcome was observed; however, larger multicenter studies are needed.

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Conflict of interest statement

The authors declare no funding or conflicts of interest.

References

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    1. Ceulemans LJ, Inci I, Van Raemdonck D. Lung donation after circulatory death. Curr Opin Organ Transplant. 2019;24:288–296.
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    1. Hessheimer AJ, Polak W, Antoine C, et al. Regulations and procurement surgery in DCD liver transplantation: expert consensus guidance from the International Liver Transplantation Society. Transplantation. 2021;105:945–951.

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