In donation after circulatory death (DCD), (thoraco)abdominal regional per-fusion (RP) restores circulation to a region of the body following death decla-ration. We systematically reviewed outcomes of solid organ transplantation after RP by searching PubMed, Embase, and Cochrane libraries. Eighty-eight articles reporting on outcomes of liver, kidney, pancreas, heart, and lung transplants or donor/organ utilization were identified. Meta-analyses were conducted when possible. Methodological quality was assessed using National Institutes of Health (NIH)-scoring tools. Case reports (13/88), case series (44/ 88), retrospective cohort studies (35/88), retrospective matched cohort studies (5/88), and case-control studies (2/88) were identified, with overall fair qual-ity. As blood viscosity and rheology change below 20 °C, studies were grouped as hypothermic (HRP, ≤20 °C) or normothermic (NRP, >20 °C) regional perfusion. Data demonstrate that RP is a safe alternative to in situ cold preser-vation (ISP) in uncontrolled and controlled DCDs. The scarce HRP data are from before 2005. NRP appears to reduce post-transplant complications, espe-cially biliary complications in controlled DCD livers, compared with ISP. Comparisons for kidney and pancreas with ISP are needed but there is no evi-dence that NRP is detrimental. Additional data on NRP in thoracic organs are needed. Whether RP increases donor or organ utilization needs further research.
A systematic review and meta-analyses of regional perfusion in donation after circulatory death solid organ transplantation / De Beule, J., Vandendriessche, K., Pengel, L.H.M., Bellini, M.I., Dark, J.H., Hessheimer, A.J., Kimenai, H.J.A.N., Knight, S.R., Neyrinck, A.P., Paredes, D., Watson, C.J.E., Rega, F., Jochmans, I.. - In: TRANSPLANT INTERNATIONAL. - ISSN 1432-2277. - (2021). [10.1111/tri.14121]
A systematic review and meta-analyses of regional perfusion in donation after circulatory death solid organ transplantation
Maria Irene Bellini;
2021
Abstract
In donation after circulatory death (DCD), (thoraco)abdominal regional per-fusion (RP) restores circulation to a region of the body following death decla-ration. We systematically reviewed outcomes of solid organ transplantation after RP by searching PubMed, Embase, and Cochrane libraries. Eighty-eight articles reporting on outcomes of liver, kidney, pancreas, heart, and lung transplants or donor/organ utilization were identified. Meta-analyses were conducted when possible. Methodological quality was assessed using National Institutes of Health (NIH)-scoring tools. Case reports (13/88), case series (44/ 88), retrospective cohort studies (35/88), retrospective matched cohort studies (5/88), and case-control studies (2/88) were identified, with overall fair qual-ity. As blood viscosity and rheology change below 20 °C, studies were grouped as hypothermic (HRP, ≤20 °C) or normothermic (NRP, >20 °C) regional perfusion. Data demonstrate that RP is a safe alternative to in situ cold preser-vation (ISP) in uncontrolled and controlled DCDs. The scarce HRP data are from before 2005. NRP appears to reduce post-transplant complications, espe-cially biliary complications in controlled DCD livers, compared with ISP. Comparisons for kidney and pancreas with ISP are needed but there is no evi-dence that NRP is detrimental. Additional data on NRP in thoracic organs are needed. Whether RP increases donor or organ utilization needs further research.| File | Dimensione | Formato | |
|---|---|---|---|
|
Bellini_Solid-organ-transplantation_2021.pdf
accesso aperto
Tipologia:
Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza:
Creative commons
Dimensione
825.78 kB
Formato
Adobe PDF
|
825.78 kB | Adobe PDF |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
