The American Society of Transplant Surgeons Consensus Statement on Normothermic Regional Perfusion

Transplantation, Journal Year: 2024, Volume and Issue: 108(2), P. 312 - 318

Published: Jan. 19, 2024

On June 3, 2023, the American Society of Transplant Surgeons convened a meeting in San Diego, California to (1) develop consensus statement with supporting data on ethical tenets thoracoabdominal normothermic regional perfusion (NRP) and abdominal NRP; (2) provide guidelines for standards practice that should govern NRP (3) implement central database collection donor recipient United States. National international leaders fields neuroscience, transplantation, critical care, NRP, Organ Procurement Organizations, transplant centers, families participated. The conference was designed focus controversial issues neurological flow function donation after circulatory death donors during propose technical necessary ensure this procedure is performed safely effectively. This article discusses major topics conclusions addressed at meeting.

Language: Английский

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The Unified Brain-Based Determination of Death Conceptually Justifies Death Determination in DCDD and NRP Protocols

The American Journal of Bioethics, Journal Year: 2024, Volume and Issue: 24(6), P. 4 - 15

Published: June 2, 2024

Organ donation after the circulatory determination of death requires permanent cessation circulation while organ brain irreversible functions. The unified brain-based connects and criteria for in as follows: systemic causes which perfusion function. relevant that must cease is to brain. Eliminating from donor ECMO circuit thoracoabdominal NRP protocols satisfies but only if complete can be proved. Despite its medical physiologic rationale, remains inconsistent with Uniform Determination Death Act.

Language: Английский

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Consensus Statement: Technical Standards for Thoracoabdominal Normothermic Regional Perfusion

The Annals of Thoracic Surgery, Journal Year: 2024, Volume and Issue: 118(4), P. 778 - 791

Published: July 19, 2024

Language: Английский

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Normothermic regional perfusion in paediatric donation after circulatory determination of death—the Oxford position statement from ELPAT

Frontiers in Transplantation, Journal Year: 2024, Volume and Issue: 3

Published: Jan. 29, 2024

OPINION article Front. Transplant., 29 January 2024Sec. Organ and Tissue Preservation Volume 3 - 2024 | https://doi.org/10.3389/frtra.2024.1320783

Language: Английский

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American Society of Transplant Surgeons Normothermic Regional Perfusion Standards: Abdominal

Transplantation, Journal Year: 2024, Volume and Issue: unknown

Published: July 16, 2024

Normothermic regional perfusion (NRP) has emerged as a vital technique in organ procurement, particularly donation after circulatory death (DCD) cases, offering the potential to optimize utilization and improve posttransplant outcomes. Recognizing its significance, American Society of Transplant Surgeons (ASTS) convened work group develop standardized recommendations for abdominal NRP United States.

Language: Английский

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Normothermic Regional Perfusion in Controlled Donation After the Circulatory Determination of Death: Understanding Where the Benefit Lies

Transplantation, Journal Year: 2024, Volume and Issue: unknown

Published: July 25, 2024

Controlled donation after the circulatory determination of death (cDCDD) has emerged as a strategy to increase availability organs for clinical use. Traditionally, from cDCDD donors have been subject standard rapid recovery (SRR) with poor posttransplant outcomes abdominal organs, particularly liver, and limited organ utilization. Normothermic regional perfusion (NRP), based on use extracorporeal membrane oxygenation devices, consists in situ that will be transplantation oxygenated blood under normothermic conditions declaration before recovery. NRP is potential solution address limitations traditional methods. It become normal practice several European countries recently introduced United States. The increased occurred result growing body evidence its association improved utilization compared SRR. However, expansion precluded by obstacles an organizational, legal, ethical nature. This article details technique both thoracoabdominal NRP. Based available evidence, it describes benefits terms thoracic addresses cost-effectiveness aspects NRP, well logistical limit implementation this innovative preservation strategy.

Language: Английский

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Knowledge gaps in heart and lung donation after the circulatory determination of death: Report of a workshop of the National Heart, Lung, and Blood Institute

The Journal of Heart and Lung Transplantation, Journal Year: 2024, Volume and Issue: 43(6), P. 1021 - 1029

Published: March 2, 2024

Language: Английский

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Normothermic Regional Perfusion in Donation After Circulatory Death for Liver Transplantation: A Narrative Review

Current Surgery Reports, Journal Year: 2024, Volume and Issue: 12(3), P. 15 - 25

Published: Feb. 3, 2024

Language: Английский

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Thoraco-abdominal normothermic regional perfusion for thoracic transplantation in the United States: current state and future directions

Current Opinion in Organ Transplantation, Journal Year: 2024, Volume and Issue: 29(3), P. 180 - 185

Published: March 14, 2024

Purpose of review To provide an update regarding the state thoracoabdominal normothermic regional perfusion (taNRP) when used for thoracic organ recovery Recent findings taNRP is growing in its utilization from donation after circulatory death donors, partly because cost effectiveness. has been shown to yield cardiac allograft recipient outcomes similar those brain-dead donors. Regarding use recover donor lungs, United Network Organ Sharing (UNOS) analysis shows that recovered lungs are noninferior, and consistently excellent at high volume centers. Despite growth, ethical debate continues, though clinical data now supports notion there no meaningful brain clamping aortic arch vessels. Summary method recovering both heart donors yields satisfactory a cost-effective manner. endorsed by American Society Transplant Surgeons, continues.

Language: Английский

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Developing and Expanding Deceased Organ Donation to its Maximum Therapeutic Potential: An Actionable Global Challenge From the 2023 Santander Summit

Transplantation, Journal Year: 2024, Volume and Issue: 109(1), P. 10 - 21

Published: Oct. 22, 2024

On November 9 and 10, 2023, the Organización Nacional de Trasplantes (ONT), under Spanish Presidency of Council European Union, convened in Santander a Global Summit entitled "Towards Convergence Transplantation: Sufficiency, Transparency Oversight." This article summarizes two distinct but related challenges elaborated at by Working Group 2 that must be overcome if we are to develop expand deceased donation worldwide achieve goal self-sufficiency organ transplantation. Challenge 1: need for unified concept death based on permanent cessation brain function. group proposed challenge 1 requires global community work toward uniform, definition human death, conceptually unifying circulatory neurological criteria around function accepting is valid criterion determine death. 2: reducing disparities increasing utilization through after determination (DCDD). DCDD, expanding DCDD situ normothermic regional perfusion, ex machine perfusion technology. Recommendations implementation described.

Language: Английский

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