Innovative surgical techniques address the organ donation crisis,. .. don't they?

Current Opinion in Organ Transplantation

Volumn 14, Issue 5, 2009, Pages 507-514

  De Ville De Goyet, Jean ^a  

^a BAMBINO GESÙ CHILDREN S HOSPITAL   (Italy)

Author keywords

Donor pool; Innovative technique; Living donor; Marginal donor; Solid organ transplantation

Indexed keywords

HUMAN; ORGAN DONOR; ORGAN TRANSPLANTATION; PEDIATRIC SURGERY; REVIEW; SURGICAL TECHNIQUE;

HUMANS; TISSUE AND ORGAN PROCUREMENT; TISSUE DONORS; UNITED STATES; WAITING LISTS;

EID: 73349083921     PISSN: 10872418     EISSN: 15317013     Source Type: Journal    
DOI: 10.1097/MOT.0b013e32833067f3     Document Type: Review

References (59)

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23. Kasahara M, Fukuda A, Yokoyama S, et al. Living donor liver transplantation with hyperreduced left lateral segments. J Pediatr Surg 2008; 43:1575-1578. The authors discuss the needs and the technique for reducing further the volume of left lateral segment liver grafts to match the very small candidates, infants and neonates. The technique is useful for this particularly challenging group of patients.
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30. Quaglia A, Portmann BC, Knisely AS, et al. Auxiliary transplantation for acute liver failure: histopathological study of native liver regeneration. Liver Transpl 2008; 10:1437-1448. Retrospective review by the leading single centre in the field of auxiliary liver transplantation. This procedure needs a careful selection of candidates and is more easily performed, technically speaking, in teens and young adults. Use in the context of emergency transplantation for small weight patients remain logistically and medically limited and paediatric teams should consider it with caution.
31. Lodge JP, Dasgupta D, Prasad KR, et al. Emergency subtotal hepatectomy: a new concept for acetaminophen-induced acute liver failure: temporary hepatic support by auxiliary orthotopic liver transplantation enables long-term success. Ann Surg 2008; 247:238-249. Retrospective single centre review. Results are similar to that of Quaglia, et al.[30• •], confirming the feasibility of that technique in the 'teens/young adult' group with the possibility of liver regeneration and stopping immunosuppression.
32. Noujaim HM, de Ville de Goyet J, Montero EFS, et al. Expanding postmortem donor pool using steatotic liver grafts: a new look. Transplantation 2009; 87:919-925. Retrospective review of a large single centre series. It confirms that liver graft steatosis has a negative impact on outcomes, but overall using these grafts allows a significant increase in organ offer that counterbalances the negative outcome for candidates who otherwise would not be offered the chance of a transplant.
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42. DuBose J, Salim A. Aggressive organ donor management protocol. J Intensive Care Med 2008; 23:367-375. A different perspective and view of intensivists on 'The' problem. Transplantation will be necessarily teamwork, more than ever.
43. Chen H, Zhang Y,Zhou L, et al. Role of basic studies in expanding thedonor pool for liver transplantation. Hepatobiliary Pancreat Dis Int 2008; 7:571-580. In the last 30 years, results of experimental works on prevention of ischaemic damage, improving cold preservation, decreasing reperfusion injury or optimizing organ recovery have been piling up, whereas clinicians were happy with techniques established two decades ago, which was right while selecting optimal donor organs. Let not forget that, 70 years ago, extracorporeal normothermic preservation perfusion techniques were studied extensively by Carrel A, with good results!
44. Kosieradzki M, Rowinski W. Ischemia/reperfusion injury in kidney transplantation: mechanisms and prevention. Transplant Proc 2008; 40:3279-3288. This is rather a textbook chapter than a paper. To forward to all specialists interested to work in the field of transplantation.
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47. Collins MJ, Moainie SL, Griffith BP, Poston RS. Preserving and evaluating hearts with ex vivo machine perfusion: an avenue to improve early graft performance and expand the donor pool. Eur J Cardiothorac Surg 2008; 34:318-325. Review of literature and experimental models on the theme that machine perfusion could also be used to resuscitate and evaluate the viability of hearts from extended criteria donors, including the nonheart-beating donor, with particular attention to how the challenges can be addressed in order to achieve consistent results.
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49. Oto T. Lung transplantation from donation after cardiac death (nonheartbeating) donors. Gen Thorac Cardiovasc Surg 2008; 56:533-538. A comprehensive review of the relevant published experimental data and clinical experiences with lung transplantation from donation after cardiac-death donors or nonheart-beating donors.
50. Neyrinck AP, Van De Wauwer C, Geudens N, et al. Comparative study of donor lung injury in heart-beating versus nonheart-beating donors. Eur J Card Thor Surg 2006; 30:628-636.
51. Hirota M, Ishino K, Fukumasu I, et al. Prediction of functional recovery of 60-min warm ischemic hearts from asphyxiated canine Non-heart-beating donors. J Heart Lung Transplant 2006; 25:239-344.
52. Ali A, White P, Dhital K, et al. cardiac recovery in a human non-heart-beating donor after extracorporeal perfusion: source for human heart donation? J Heart Lung Transplant 2009; 28:290-293. The author introduced the concept of immediate in-situ organ resuscitation in a nonheart-beating controlled donor, an exceptional procedure. This will be for sure followed by other clinical experimentation, opening access to a new pool of potential heart donors.
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56. Foley DP, Fernandez LA, Leverson G, et al. Donation after cardiac death. The University of Wisconsin experience with liver transplantation. Ann Surg 2005; 242:724-731. (Pubitemid 41567129)
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58. Chan EY, Olson LC, Kisthard JA, et al. Ischemic cholangiopathy following liver transplantation from donation after cardiac death donors. Liver Transpl 2008; 14:604-610. This paper highlights the risks of organ procured from cardiac death donors and the importance of shortening ischaemic time for these transplants. Paediatric teams should avoid adding a complementary reduction or split procedure.
59. Volk ML, Lok AS, Pelletier SJ, et al. Impact of the model for end-stage liver disease allocation policy on the use of high-risk organs for liver transplantation. Gastroenterology 2008; 135:1568-1574. A very contradictory audit showing the unintended consequences of the MELD allocation policy. Health systems and organ-sharing organizations will have to rethink again about equipoise and ethics of existing allocation rules.