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A metabolic approach during normothermic regional perfusion in uncontrolled donors after circulatory death—A pilot study
Author(s) -
Peris Adriano,
Lazzeri Chiara,
Bonizzoli Manuela,
Guetti Cristiana,
Tadini Buoninsegni Laura,
Fulceri Giorgio,
Ticali Pier Francesco,
Chiostri Marco,
Li Marzi Vincenzo,
Serni Sergio,
Migliaccio Maria Luisa
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13387
Subject(s) - medicine , creatinine , splanchnic , perfusion , machine perfusion , circulatory system , liver transplantation , warm ischemia , ischemia , organ donation , transplantation , cardiology , reperfusion injury , hemodynamics
The use of donation after circulatory death ( DCD ) has increased significantly to face the persistent mismatch between supply and demand of organs for transplantation. While controlled (c) DCD s have warm ischemic time ( WIT ) that can be estimated, the WIT is often inexact and extended in uncontrolled DCD ( uDCD ), making assessment of injury difficult. We aimed at investigating the effects of cold ischemia on potential donor organ damage in the course of nRP by assessing the dynamic variations of transaminases and creatinine values in 17 uDCD donors. In our series, lactate values did not show significant changes during the study period ( P = 0.147). Creatinine values did not significantly changed while transaminases progressive increased throughout the study period, even if it was significant only for AST ( P = 0.035). According to our data, nRP duration affects splanchnic organs, being the liver sensitive to hypoperfusion, and serial biochemical measurements could help in detecting organ functional status.