Liver Transplant Using Donors After Unexpected Cardiac Death: Novel Preservation Protocol and Acceptance Criteria

摘要: Donors after cardiac death (DCD) suffer irreversible arrest prior to donation. We describe our liver transplant experience with DCD whose is unexpected, not following the removal of ventilatory support, whom we maintain normothermic extracorporeal membrane oxygenation (NECMO). A potential donor goes into outside hospital and brought under continuous cardiopulmonary resuscitation (CPR). The declared dead placed on a cardiocompressor. Femoral vessels are cannulated connected bypass (CPB) establish NECMO. Blood parameters CPB pump flow monitored throughout NECMO, which continued until cold preservation. From April 2002 May 2006, 10 40 livers were transplanted. Only one graft was lost primary nonfunction (PNF) another hepatic artery thrombosis. Posttransplant function good. Certain parameters, such as CPR NECMO times, transaminases during age, determined viability grafts used criteria for their acceptance. Though considered marginal, unexpected can represent an important source viable if strict acceptance employed they maintained recovery.