Open AccessSuccessful Kidney and Lung Transplantation From a Deceased Donor With Blunt Abdominal Trauma and Intestinal Perforation
Author(s) -
Tim C. van Smaalen,
Christina Krikke,
Jan Willem Haveman,
L. W. Ernest van Heurn
Publication year - 2016
Publication title -
transplantation direct
Language(s) - English
Resource type - Journals
ISSN - 2373-8731
DOI - 10.1097/txd.0000000000000572
Subject(s) - medicine , contraindication , surgery , cannula , abdomen , perforation , gastrointestinal perforation , blunt , abdominal trauma , transplantation , peritonitis , pathology , materials science , alternative medicine , punching , metallurgy
The number of organ donors is limited by many contraindications for donation and poor quality of potential organ donors. Abdominal infection is a generally accepted contraindication for donation of abdominal organs. We present a 43-year-old man with lethal brain injury, blunt abdominal trauma, and intestinal perforation. After withdrawal of life-sustaining treatment and circulatory arrest, a minilaparotomy confirmed abdominal contamination with intestinal content. After closure of the abdomen, organs were preserved with in situ preservation with an aortic cannula inserted via the femoral artery. Thereafter, the kidneys were procured via bilateral lumbotomy to reduce the risk of direct bacterial contamination; lungs were retrieved following a standard practice. There was no bacterial or fungal growth in the machine preservation fluid of both kidneys. All organs were successfully transplanted, without postoperative infection, and functioned well after 6 months. We hereby show that direct contamination of organs can be avoided with the use of in situ preservation and retroperitoneal procurement. Intestinal perforation is not an absolute contraindication for donation, although the risk of bacterial or fungal transmission has to be evaluated per cas