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Andres AM, Encinas JL, Sánchez-Galán A, Rodríguez JS, Estefania K, Sacristan RG, Alcolea A, Serrano P, Estébanez B, Leon IV, Burgos P, Rocafort AG, Ramchandani B, Calderón B, Verdú C, Jimenez E, Talayero P, Stringa P, Navarro IDLP, Ramos E, Oliveros FH. First case report of multivisceral transplant from a deceased cardiac death donor. Am J Transplant 2023; 23:577-581. [PMID: 36725427 DOI: 10.1016/j.ajt.2022.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/27/2022] [Accepted: 12/08/2022] [Indexed: 01/06/2023]
Abstract
The current shortage of pediatric multivisceral donors accounts for the long time and mortality on the waiting list of pediatric patients. The use of donors after cardiac death, especially after the outbreak of normothermic regional perfusion, has increased in recent years for all solid organs except the intestine, mainly because of its higher susceptibility to ischemia-reperfusion injury. We present the first literature case of multivisceral donors after cardiac death transplantation in a 13-month-old recipient from a 2.5-month-old donor. Once exitus was certified, an extracorporeal membrane oxygenation circuit was established, cannulating the aorta and infrarenal vena cava, while the supra-aortic branches were clamped. The abdominal organs completely recovered from ischemia through normothermic regional perfusion (extracorporeal membrane oxygenation initially and beating heart later). After perfusion with the preservation solution, the multivisceral graft was uneventfully implanted. Two months later, the patient was discharged without any complications. This case demonstrates the possibility of reducing the time spent on the waiting list for these patients.
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Affiliation(s)
- Ane M Andres
- Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (Idipaz), La Paz University Hospital, Madrid, Spain; European Reference Network on Transplantation in Children (TransplantChild ERN), Madrid, Spain; Anatomy, Histology and Neuroscience Department, University Autonoma of Madrid, Madrid, Spain.
| | - Jose Luis Encinas
- Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain
| | | | - Javier Serradilla Rodríguez
- Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (Idipaz), La Paz University Hospital, Madrid, Spain
| | - Karla Estefania
- Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Rocio Gonzalez Sacristan
- Pediatric Gastroenterology Department, Intestinal Rehabilitation Unit, La Paz University Hospital, Madrid, Spain
| | - Alida Alcolea
- Pediatric Gastroenterology Department, Intestinal Rehabilitation Unit, La Paz University Hospital, Madrid, Spain
| | - Pilar Serrano
- Pediatric Gastroenterology Department, Intestinal Rehabilitation Unit, La Paz University Hospital, Madrid, Spain
| | - Belén Estébanez
- Intensive Care Unit and Transplant Coordination Unit, La Paz University Hospital, Madrid, Spain
| | - Iñigo Velasco Leon
- Pediatric Perfusion Department, La Paz University Hospital, Madrid, Spain; Pediatric Cardiovascular Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Paula Burgos
- Pediatric Perfusion Department, La Paz University Hospital, Madrid, Spain; Pediatric Cardiovascular Surgery Department, La Paz University Hospital, Madrid, Spain
| | | | - Bunty Ramchandani
- Pediatric Cardiovascular Surgery Department, La Paz University Hospital, Madrid, Spain
| | - Belén Calderón
- Pediatric Intensive Care Unit Department, La Paz University Hospital, Madrid, Spain
| | - Cristina Verdú
- Pediatric Intensive Care Unit Department, La Paz University Hospital, Madrid, Spain
| | - Esperanza Jimenez
- Pediatric Anesthesiology Department, La Paz University Hospital, Madrid, Spain
| | - Paloma Talayero
- Immunology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Pablo Stringa
- Institute for Immunological and Physiopathological Studies (IIFP-CONICET-UNLP), National University of La Plata, Buenos Aires, Argentina
| | | | - Esther Ramos
- Pediatric Gastroenterology Department, Intestinal Rehabilitation Unit, La Paz University Hospital, Madrid, Spain
| | - Francisco Hernandez Oliveros
- Pediatric Surgery Department, La Paz University Hospital, Madrid, Spain; La Paz Research Institute (Idipaz), La Paz University Hospital, Madrid, Spain; European Reference Network on Transplantation in Children (TransplantChild ERN), Madrid, Spain
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