Contemporary considerations in solid organ transplantation utilizing DCD donors
Introduction: Donation after cardiac death (DCD) has been leading the way to help bridge the growing gap between availability of donors and recipients on waitlist. With advances in technology and our understanding of DCD donation the safety profile is growing. It is becoming an increasing viable opt...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Transplantation Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451959622000269 |
| _version_ | 1811177673630679040 |
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| author | Farjad Siddiqui Yazan Al-Adwan Jayanthan Subramanian Mitchell L. Henry |
| author_facet | Farjad Siddiqui Yazan Al-Adwan Jayanthan Subramanian Mitchell L. Henry |
| author_sort | Farjad Siddiqui |
| collection | DOAJ |
| description | Introduction: Donation after cardiac death (DCD) has been leading the way to help bridge the growing gap between availability of donors and recipients on waitlist. With advances in technology and our understanding of DCD donation the safety profile is growing. It is becoming an increasing viable option even in marginal settings. Discussion: The ethos surroundings DCD is still a matter of contention but there is support and collaboration from larger societies and establishments with development of standardizing protocols. Preparation is key. Experience of the procurement and transplanting surgeons are pivotal. There are multiple moving parts and for the success of a DCD program, dedication is needed from the donor hospitals, organ procurement organizations and the transplant centers. Previous practices based on anecdotal experiences are now either supported by or refuted by increasing evidence and data, based on the development of consensus-based guidelines with the end goal of having uniform outcomes. Normothermic regional and machine perfusion have expanded options in the DCD world, challenging the limits and expanding our paradigm. Recognition of the weaknesses and organ specific complications allow the clinician to make choices for optimal outcomes. These advancements have allowed outcomes to be optimized. Conclusions: Expanding the organ donor pool is one solution to increase the availability of organs for transplantation. Increasing the attention to and the use of DCD organs combined with machine and normothermic perfusion is a future strategy to obtain ongoing clinical success in organ transplantation and lower the waiting list mortality. |
| first_indexed | 2024-04-11T06:05:04Z |
| format | Article |
| id | doaj.art-39dab29f9c784c7cbd241b7318ceedb7 |
| institution | Directory Open Access Journal |
| issn | 2451-9596 |
| language | English |
| last_indexed | 2024-04-11T06:05:04Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Transplantation Reports |
| spelling | doaj.art-39dab29f9c784c7cbd241b7318ceedb72022-12-22T04:41:31ZengElsevierTransplantation Reports2451-95962022-12-0174100118Contemporary considerations in solid organ transplantation utilizing DCD donorsFarjad Siddiqui0Yazan Al-Adwan1Jayanthan Subramanian2Mitchell L. Henry3Division of Transplantation, Comprehensive Transplant Center, Department of Surgery, The Ohio State Wexner Medical Center, Columbus, OH, USADivision of Transplantation, University of Virginia Health System, Charlottesville, VA, USADivision of Transplantation, Comprehensive Transplant Center, Department of Surgery, The Ohio State Wexner Medical Center, Columbus, OH, USADivision of Transplantation, Comprehensive Transplant Center, Department of Surgery, The Ohio State Wexner Medical Center, Columbus, OH, USA; Corresponding author.Introduction: Donation after cardiac death (DCD) has been leading the way to help bridge the growing gap between availability of donors and recipients on waitlist. With advances in technology and our understanding of DCD donation the safety profile is growing. It is becoming an increasing viable option even in marginal settings. Discussion: The ethos surroundings DCD is still a matter of contention but there is support and collaboration from larger societies and establishments with development of standardizing protocols. Preparation is key. Experience of the procurement and transplanting surgeons are pivotal. There are multiple moving parts and for the success of a DCD program, dedication is needed from the donor hospitals, organ procurement organizations and the transplant centers. Previous practices based on anecdotal experiences are now either supported by or refuted by increasing evidence and data, based on the development of consensus-based guidelines with the end goal of having uniform outcomes. Normothermic regional and machine perfusion have expanded options in the DCD world, challenging the limits and expanding our paradigm. Recognition of the weaknesses and organ specific complications allow the clinician to make choices for optimal outcomes. These advancements have allowed outcomes to be optimized. Conclusions: Expanding the organ donor pool is one solution to increase the availability of organs for transplantation. Increasing the attention to and the use of DCD organs combined with machine and normothermic perfusion is a future strategy to obtain ongoing clinical success in organ transplantation and lower the waiting list mortality.http://www.sciencedirect.com/science/article/pii/S2451959622000269Donation after cardiac deathOrgan preservationOrgan procurementTransplantationNormothermic perfusion |
| spellingShingle | Farjad Siddiqui Yazan Al-Adwan Jayanthan Subramanian Mitchell L. Henry Contemporary considerations in solid organ transplantation utilizing DCD donors Transplantation Reports Donation after cardiac death Organ preservation Organ procurement Transplantation Normothermic perfusion |
| title | Contemporary considerations in solid organ transplantation utilizing DCD donors |
| title_full | Contemporary considerations in solid organ transplantation utilizing DCD donors |
| title_fullStr | Contemporary considerations in solid organ transplantation utilizing DCD donors |
| title_full_unstemmed | Contemporary considerations in solid organ transplantation utilizing DCD donors |
| title_short | Contemporary considerations in solid organ transplantation utilizing DCD donors |
| title_sort | contemporary considerations in solid organ transplantation utilizing dcd donors |
| topic | Donation after cardiac death Organ preservation Organ procurement Transplantation Normothermic perfusion |
| url | http://www.sciencedirect.com/science/article/pii/S2451959622000269 |
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