Uncontrolled Donors after Cardiac Death: Clinical Application of Normothermic Perfusion in situ for Kidney Resuscitation



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Abstract

Uncontrolled organ donation after circulatory determination of death could be a promising perspective, but the warm ischemic time damages restrict the use of them. Between 2009 and 2010, organ procurement service of St Petersburg, Russia, used 17 patients who had experienced unexpected circulatory death as uncontrolled donors with warm ischemic time from 45 to 91 minutes. For resuscitation kidney suffered ischemia, normothermic extracorporai abdominal perfusion in situ with leukocyte depletion was applied. Kidney transplantation was performed for 34 patients. Immediate functioning of kidney grafts was observed in 11 of the 34 cases. The 1 -year graft survival rate was 97% (n=33), rejection rate 2,9% (n=1 ). At the end of first year of observation, the average creatinine level was 1,81 ±0,05 mg/dL. Based on our experience, we posit that normothermic extracorporal perfusion can be solely considered as a resuscitation practice for kidneys from uncontrolled donors that critically expands warm ischemia time. The results of the 1 -year follow-up clinical experience with this procedure provide evidence that transplantation of organs that are "resuscitated” using this method are satisfactory and meet the generally accepted criteria for graft survival and functioning.

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S F Bagnenko

I.I. Djanelidze State Research Institute for Emergency, St. Petersburg

O N Reznik

I.I. Djanelidze State Research Institute for Emergency, St. Petersburg

Email: onreznik@yahoo.com

A E Scvortsov

I.I. Djanelidze State Research Institute for Emergency, St. Petersburg

A V Lopota

Central Research Institute of Robotics and Technical Cybernetics, St. Petersburg

K Y Senchik

Central Research Institute of Robotics and Technical Cybernetics, St. Petersburg

A O Reznik

I.I. Djanelidze State Research Institute for Emergency, St. Petersburg

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Copyright (c) 2011 Bagnenko S.F., Reznik O.N., Scvortsov A.E., Lopota A.V., Senchik K.Y., Reznik A.O.

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