1 / 15

Organ Donation in DCD: 10 Year Experience at the University o f Michigan

Organ Donation in DCD: 10 Year Experience at the University o f Michigan. A Rojas-Pena, MD; L Sall, BS; K. Koch, BS; E Cooley, RN; M Gravel, RN; R Bartlett, MD ; J Punch, MD; S Pelletier, MD University of Michigan Health System Department of Surgery, Section of Transplantation and the

vienna
Download Presentation

Organ Donation in DCD: 10 Year Experience at the University o f Michigan

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Organ Donation in DCD: 10 Year Experience at the University of Michigan A Rojas-Pena, MD; L Sall, BS; K. Koch, BS; E Cooley, RN; M Gravel, RN; R Bartlett, MD; J Punch, MD; S Pelletier, MD University of Michigan Health System Department of Surgery, Section of Transplantation and the Extracorporeal Life Support Program

  2. DCD History at UM Large transplant program + large extracorporeal life support (ECS) program • 2000, both programs were combined Extracorporeal support (ECS)  resuscitate and recover abdominal organs in controlled DCD (Maastricht category III) when the family requests organ donation • Successful recovery / transplantation of kidneys, liver and pancreas • Initial experience reported in 2005 with 20 ECS-DCD Magliocca, et al. The Journal of trauma 2005;58(6):1095-101; discussion 1101-2.

  3. Objectives • Retrospective review of DCD program: • 10-year experience • cases between October 2000 to August 2010 • Update UM first series study on ECS assisted donation in controlled DCD ECS-cDCD

  4. Methods • Potential cDCD abdominal organs OK for procurement after dead • Recipient outcome data of: • Kidneys and livers procured and transplanted at UM only • RR technique (RR-DCD group) vs • ECS technique (ECS-DCD group)

  5. DCD selection • <65yo / Maastricht type III • Severe irreversible brain injury  NO BD criteria • Intensive Care Unit (ICU) on MV and/or life support • Cardio-circulatory arrest after planned withdrawal of life support • Family for donation • Consent for cannulation • No contraindications to transplant grafts

  6. UM – ECS circuit

  7. Final DCD at UM 37 ECS-DCD & 25 RR-DCD

  8. ORPD & OTPD Rates January-June 2011 DCD: 2.45 ORPD & 2.0 OTPD / Discard rate: 18%

  9. Summary of the ECS run

  10. ECS-DCD Complications

  11. UM Outcomes Renal Grafts • 37 patients (5 yr follow up) DGF: Need of HD within the first week post-transplantation - 50% due to hyperkalemia

  12. Graft Survival Rates US graft survival rate: 89% 66% 77%

  13. Outcomes Livers • 20 DCD liver recipients • Full records / HIPPA (3 year follow up) • Recipient MELD score = 15-17 Ischemic cholangiopathy: 15% (both groups)

  14. Take Home Message

  15. Acknowledgments ECLS Program Staff • Pula Baldridge, RN • Manager • Sheri Bignall Faculty • Jonathan Haft • ECLS Director • Gail Annich • ECLS co-Director • George Mychaliska • Robert Bartlett ECLS Lab • Lauren Sall • Kelly Koch Transplant Team • Jeff Punch • Director Transplant Program • Swan Pelletier • Larry Slate II • Chief Transplant perfusionist

More Related