Brain Death Donors on Extracorporeal Membrane Oxygenation Support.
Exp Clin Transplant
; 22(6): 421-425, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-39072511
ABSTRACT
OBJECTIVES:
We investigated donors with brain death on extracorporeal membrane oxygenation support, a clinically challenging situation due to hemodynamic instability frequently encountered in these donors, which may threaten organ function. MATERIALS ANDMETHODS:
We described our experience with 15 utilized brain death donors on extracorporeal membrane oxygenation support, consecutively admit-ted in our intensive care unit (which is a referral center for extracorporeal membrane oxygenation) from 2018 to 2023. We investigated whether utilization rate for brain death donors on extracor-poreal membrane oxygenation was affected by the introduction of a monitoring hemodynamic schedule during the 6-hour observation period.RESULTS:
The utilization rate was 78% in period 1 and 88% in period 2. No statistically significant differences were observed for age, sex, and the incidence of cardiovascular risk factors between period 1 and period 2. The cause of death was postanoxic encephalopathy in all but 1 donor, who was on venovenous extracorporeal membrane oxygenation for refractory respiratory failure and developed cerebral hemorrhage. Number of organs per donor was 2 in all the population with no significant differences between period 1 and period 2. In the overall population, 15 livers were transplanted, 11 kidneys, 1 heart, and 1 pancreas. In our population, left ventricular ejection fraction severe dysfunction was observed in all donors except in the donor on venovenous extracorporeal membrane oxygenation; the organ from this donor was deemed unsuitable for transplant. No significant differences were observed in hemodynamic data between the 2 subgroups. All donors were on 2 vasoactive drugs (norepinephrine and vasopressin) to maintain adequate perfusion (mean arterial pressure >60 mm Hg). Three donors were oligoanuric (due to postarrest acute renal failure). CONCLUISONS In our series of 15 consecutive brain death donors on extracorporeal membrane oxygenation, a strict monitoring regimen during the 6-hour obser-vation period was associated with a higher utilization rate.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Donantes de Tejidos
/
Muerte Encefálica
/
Oxigenación por Membrana Extracorpórea
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Selección de Donante
Límite:
Adult
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Exp Clin Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2024
Tipo del documento:
Article
País de afiliación:
Italia
Pais de publicación:
Turquía