Single center utilization and post‐transplant outcomes of thoracoabdominal normothermic regional perfusion deceased cardiac donor organs

Introduction Thoracoabdominal normothermic regional perfusion (TA‐NRP) following cardiac death is an emerging multivisceral organ procurement technique. Recent national studies on outcomes of presumptive TA‐NRP‐procured organs are limited by potential misclassification since TA‐NRP is not differenti...

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Published in:Clinical transplantation 2024-03, Vol.38 (3), p.e15269-n/a
Main Authors: Motter, Jennifer D., Jaffe, Ian S., Moazami, Nader, Smith, Deane E., Kon, Zachary N., Piper, Greta L., Sommer, Philip M., Reyentovich, Alex, Chang, Stephanie H., Aljabban, Imad, Montgomery, Robert A., Segev, Dorry L., Massie, Allan B., Lonze, Bonnie E.
Format: Article
Language:English
Subjects:
Adult
Benzidines
Brain Death
donation after cardiac death
Heart
heart transplantation
Humans
kidney transplantation
liver transplantation
lung transplantation
Perfusion
thoracoabdominal normothermic reperfusion
Tissue and Organ Procurement
Tissue Donors
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Summary:Introduction Thoracoabdominal normothermic regional perfusion (TA‐NRP) following cardiac death is an emerging multivisceral organ procurement technique. Recent national studies on outcomes of presumptive TA‐NRP‐procured organs are limited by potential misclassification since TA‐NRP is not differentiated from donation after cardiac death (DCD) in registry data. Methods We studied 22 donors whose designees consented to TA‐NRP and organ procurement performed at our institution between January 20, 2020 and July 3, 2022. We identified these donors in SRTR to describe organ utilization and recipient outcomes and compared them to recipients of traditional DCD (tDCD) and donation after brain death (DBD) organs during the same timeframe. Results All 22 donors progressed to cardiac arrest and underwent TA‐NRP followed by heart, lung, kidney, and/or liver procurement. Median donor age was 41 years, 55% had anoxic brain injury, 45% were hypertensive, 0% were diabetic, and median kidney donor profile index was 40%. TA‐NRP utilization was high across all organ types (88%–100%), with a higher percentage of kidneys procured via TA‐NRP compared to tDCD (88% vs. 72%, p = .02). Recipient and graft survival ranged from 89% to 100% and were comparable to tDCD and DBD recipients (p ≥ .2). Delayed graft function was lower for kidneys procured from TA‐NRP compared to tDCD donors (27% vs. 44%, p = .045). Conclusion Procurement from TA‐NRP donors yielded high organ utilization, with outcomes comparable to tDCD and DBD recipients across organ types. Further large‐scale study of TA‐NRP donors, facilitated by its capture in the national registry, will be critical to fully understand its impact as an organ procurement technique.
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.15269