Tuscany Normothermic Regional Perfusion Mobile Teams for Controlled Donation After Circulatory Death
ABSTRACT Introduction To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local extracorporeal membrane oxygenation (ECMO) team, some countries have launched a local cDCD network with an ECMO mobile team for normotherm...
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| Veröffentlicht in: | Clinical transplantation 2024-08, Vol.38 (8), p.e15429-n/a |
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| creator | Lazzeri, Chiara Manuela, Bonizzoli Bagatti, Sara Antonelli, Stefano Pane, Paolo Lo Ghinolfi, Davide Peris, Adriano |
| description | ABSTRACT
Introduction
To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local extracorporeal membrane oxygenation (ECMO) team, some countries have launched a local cDCD network with an ECMO mobile team for normothermic regional perfusion (NRP). In the Tuscany region, in 2021, the Regional Transplant Authority launched a cDCD program to make the cDCD pathway feasible even in peripheral hospitals with NRP mobile teams, which were “converted” existing ECMO mobile teams, composed of highly skilled and experienced personnel.
Methods
We describe the Tuscany cDCD program, (2021–2023), for cDCD from peripheral hospitals with NRP mobile teams.
Results
Twenty‐six cDCDs (26/40, 65%) came from peripheral hospitals. Following the launch of the cDCD program, cDCDs from peripheral hospitals increased, from 33% (2021) to 75% (2022 and 2023) of the overall cDCDs. The mean age was 63 years, with older donors (>75 years) in half the cases. The median warm ischemia time was 45 min (20 min are required by the Italian law for death certification), ranging from 35 to 59 min. Among the 20 livers retrieved and 18 kidneys retrieved, 16 livers, and 11 kidneys (single kidney transplantation) were transplanted, after ex vivo reperfusion, respectively.
Conclusions
The use of NRP mobile teams proved to be feasible and safe in the management of cDCD in peripheral hospitals. No complications were reported with NRP despite the advanced age of most cDCDs. |
| doi_str_mv | 10.1111/ctr.15429 |
| format | Article |
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Introduction
To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local extracorporeal membrane oxygenation (ECMO) team, some countries have launched a local cDCD network with an ECMO mobile team for normothermic regional perfusion (NRP). In the Tuscany region, in 2021, the Regional Transplant Authority launched a cDCD program to make the cDCD pathway feasible even in peripheral hospitals with NRP mobile teams, which were “converted” existing ECMO mobile teams, composed of highly skilled and experienced personnel.
Methods
We describe the Tuscany cDCD program, (2021–2023), for cDCD from peripheral hospitals with NRP mobile teams.
Results
Twenty‐six cDCDs (26/40, 65%) came from peripheral hospitals. Following the launch of the cDCD program, cDCDs from peripheral hospitals increased, from 33% (2021) to 75% (2022 and 2023) of the overall cDCDs. The mean age was 63 years, with older donors (>75 years) in half the cases. The median warm ischemia time was 45 min (20 min are required by the Italian law for death certification), ranging from 35 to 59 min. Among the 20 livers retrieved and 18 kidneys retrieved, 16 livers, and 11 kidneys (single kidney transplantation) were transplanted, after ex vivo reperfusion, respectively.
Conclusions
The use of NRP mobile teams proved to be feasible and safe in the management of cDCD in peripheral hospitals. No complications were reported with NRP despite the advanced age of most cDCDs.</description><identifier>ISSN: 0902-0063</identifier><identifier>ISSN: 1399-0012</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.15429</identifier><identifier>PMID: 39113667</identifier><language>eng</language><publisher>Denmark</publisher><subject>Adult ; Aged ; controlled donation after circulatory death ; Extracorporeal Membrane Oxygenation ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Italy ; Kidney Transplantation ; Liver Transplantation ; Male ; Middle Aged ; mobile teams ; normothermic regional perfusion ; Organ Preservation - methods ; Perfusion - methods ; procurement ; Prognosis ; regional organization ; Tissue and Organ Harvesting - methods ; Tissue and Organ Procurement - methods ; Tissue and Organ Procurement - organization & administration ; Tissue Donors - supply & distribution</subject><ispartof>Clinical transplantation, 2024-08, Vol.38 (8), p.e15429-n/a</ispartof><rights>2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2159-bbe47a82c4502d4a85523e78a2297bc3c742322759f0d5f3754e68554e8d48313</cites><orcidid>0000-0003-0131-4450</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fctr.15429$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fctr.15429$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39113667$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lazzeri, Chiara</creatorcontrib><creatorcontrib>Manuela, Bonizzoli</creatorcontrib><creatorcontrib>Bagatti, Sara</creatorcontrib><creatorcontrib>Antonelli, Stefano</creatorcontrib><creatorcontrib>Pane, Paolo Lo</creatorcontrib><creatorcontrib>Ghinolfi, Davide</creatorcontrib><creatorcontrib>Peris, Adriano</creatorcontrib><title>Tuscany Normothermic Regional Perfusion Mobile Teams for Controlled Donation After Circulatory Death</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>ABSTRACT
Introduction
To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local extracorporeal membrane oxygenation (ECMO) team, some countries have launched a local cDCD network with an ECMO mobile team for normothermic regional perfusion (NRP). In the Tuscany region, in 2021, the Regional Transplant Authority launched a cDCD program to make the cDCD pathway feasible even in peripheral hospitals with NRP mobile teams, which were “converted” existing ECMO mobile teams, composed of highly skilled and experienced personnel.
Methods
We describe the Tuscany cDCD program, (2021–2023), for cDCD from peripheral hospitals with NRP mobile teams.
Results
Twenty‐six cDCDs (26/40, 65%) came from peripheral hospitals. Following the launch of the cDCD program, cDCDs from peripheral hospitals increased, from 33% (2021) to 75% (2022 and 2023) of the overall cDCDs. The mean age was 63 years, with older donors (>75 years) in half the cases. The median warm ischemia time was 45 min (20 min are required by the Italian law for death certification), ranging from 35 to 59 min. Among the 20 livers retrieved and 18 kidneys retrieved, 16 livers, and 11 kidneys (single kidney transplantation) were transplanted, after ex vivo reperfusion, respectively.
Conclusions
The use of NRP mobile teams proved to be feasible and safe in the management of cDCD in peripheral hospitals. No complications were reported with NRP despite the advanced age of most cDCDs.</description><subject>Adult</subject><subject>Aged</subject><subject>controlled donation after circulatory death</subject><subject>Extracorporeal Membrane Oxygenation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Italy</subject><subject>Kidney Transplantation</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>mobile teams</subject><subject>normothermic regional perfusion</subject><subject>Organ Preservation - methods</subject><subject>Perfusion - methods</subject><subject>procurement</subject><subject>Prognosis</subject><subject>regional organization</subject><subject>Tissue and Organ Harvesting - methods</subject><subject>Tissue and Organ Procurement - methods</subject><subject>Tissue and Organ Procurement - organization & administration</subject><subject>Tissue Donors - supply & distribution</subject><issn>0902-0063</issn><issn>1399-0012</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtOwzAQRS0EoqWw4AeQl7BIG9txnCyrlJdUHqrCOnKcCQ1K4mInQvl7XFLYMZu5mjm6i4PQJfHnxM1CdWZOeEDjIzQlLI493yf0GE392Kcuh2yCzqz9cNeQhPwUTVhMCAtDMUVF2lsl2wE_a9PobgumqRTewHulW1njVzBlb13GTzqvasApyMbiUhuc6LYzuq6hwCvHdntoWXbgPpVRfS07bQa8Atltz9FJKWsLF4c9Q293t2ny4K1f7h-T5dpTlPDYy3MIhIyoCrhPi0BGnFMGIpKUxiJXTImAMkoFj0u_4CUTPIDQQQFERRAxwmboeuzdGf3Zg-2yprIK6lq2oHubMSckZFyIPXozospoaw2U2c5UjTRDRvxsLzVzUrMfqY69OtT2eQPFH_lr0QGLEfhyiob_m7Ik3YyV32pjgIc</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Lazzeri, Chiara</creator><creator>Manuela, Bonizzoli</creator><creator>Bagatti, Sara</creator><creator>Antonelli, Stefano</creator><creator>Pane, Paolo Lo</creator><creator>Ghinolfi, Davide</creator><creator>Peris, Adriano</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0131-4450</orcidid></search><sort><creationdate>202408</creationdate><title>Tuscany Normothermic Regional Perfusion Mobile Teams for Controlled Donation After Circulatory Death</title><author>Lazzeri, Chiara ; Manuela, Bonizzoli ; Bagatti, Sara ; Antonelli, Stefano ; Pane, Paolo Lo ; Ghinolfi, Davide ; Peris, Adriano</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2159-bbe47a82c4502d4a85523e78a2297bc3c742322759f0d5f3754e68554e8d48313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>controlled donation after circulatory death</topic><topic>Extracorporeal Membrane Oxygenation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Italy</topic><topic>Kidney Transplantation</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>mobile teams</topic><topic>normothermic regional perfusion</topic><topic>Organ Preservation - methods</topic><topic>Perfusion - methods</topic><topic>procurement</topic><topic>Prognosis</topic><topic>regional organization</topic><topic>Tissue and Organ Harvesting - methods</topic><topic>Tissue and Organ Procurement - methods</topic><topic>Tissue and Organ Procurement - organization & administration</topic><topic>Tissue Donors - supply & distribution</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lazzeri, Chiara</creatorcontrib><creatorcontrib>Manuela, Bonizzoli</creatorcontrib><creatorcontrib>Bagatti, Sara</creatorcontrib><creatorcontrib>Antonelli, Stefano</creatorcontrib><creatorcontrib>Pane, Paolo Lo</creatorcontrib><creatorcontrib>Ghinolfi, Davide</creatorcontrib><creatorcontrib>Peris, Adriano</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lazzeri, Chiara</au><au>Manuela, Bonizzoli</au><au>Bagatti, Sara</au><au>Antonelli, Stefano</au><au>Pane, Paolo Lo</au><au>Ghinolfi, Davide</au><au>Peris, Adriano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tuscany Normothermic Regional Perfusion Mobile Teams for Controlled Donation After Circulatory Death</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2024-08</date><risdate>2024</risdate><volume>38</volume><issue>8</issue><spage>e15429</spage><epage>n/a</epage><pages>e15429-n/a</pages><issn>0902-0063</issn><issn>1399-0012</issn><eissn>1399-0012</eissn><abstract>ABSTRACT
Introduction
To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local extracorporeal membrane oxygenation (ECMO) team, some countries have launched a local cDCD network with an ECMO mobile team for normothermic regional perfusion (NRP). In the Tuscany region, in 2021, the Regional Transplant Authority launched a cDCD program to make the cDCD pathway feasible even in peripheral hospitals with NRP mobile teams, which were “converted” existing ECMO mobile teams, composed of highly skilled and experienced personnel.
Methods
We describe the Tuscany cDCD program, (2021–2023), for cDCD from peripheral hospitals with NRP mobile teams.
Results
Twenty‐six cDCDs (26/40, 65%) came from peripheral hospitals. Following the launch of the cDCD program, cDCDs from peripheral hospitals increased, from 33% (2021) to 75% (2022 and 2023) of the overall cDCDs. The mean age was 63 years, with older donors (>75 years) in half the cases. The median warm ischemia time was 45 min (20 min are required by the Italian law for death certification), ranging from 35 to 59 min. Among the 20 livers retrieved and 18 kidneys retrieved, 16 livers, and 11 kidneys (single kidney transplantation) were transplanted, after ex vivo reperfusion, respectively.
Conclusions
The use of NRP mobile teams proved to be feasible and safe in the management of cDCD in peripheral hospitals. No complications were reported with NRP despite the advanced age of most cDCDs.</abstract><cop>Denmark</cop><pmid>39113667</pmid><doi>10.1111/ctr.15429</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-0131-4450</orcidid></addata></record> |
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| subjects | Adult Aged controlled donation after circulatory death Extracorporeal Membrane Oxygenation Female Follow-Up Studies Graft Survival Humans Italy Kidney Transplantation Liver Transplantation Male Middle Aged mobile teams normothermic regional perfusion Organ Preservation - methods Perfusion - methods procurement Prognosis regional organization Tissue and Organ Harvesting - methods Tissue and Organ Procurement - methods Tissue and Organ Procurement - organization & administration Tissue Donors - supply & distribution |
| title | Tuscany Normothermic Regional Perfusion Mobile Teams for Controlled Donation After Circulatory Death |
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