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Abdominal normothermic regional perfusion in donation after circulatory death: a systematic review and critical appraisal

Abstract:

Background. Abdominal normothermic regional perfusion (aNRP) for donation after circulatory death is an emerging organ preservation technique that might lead to increased organ utilization per donor by facilitating viability testing, improving transplant outcome by early reversal of ischemia, and decreasing the risk of unintentional surgical damage. The aim of the current review is to evaluate the recent literature on the added value of aNRP when compared to local standard perfusion technique.

Methods. The Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline for systematic reviews was used, and relevant literature databases were searched. Primary outcomes were organ utilization rate and patient and graft survival after 1 year. Secondary outcomes included delayed graft function, primary nonfunction, serum creatinine, and biliary complications.

Results. A total of 24 articles were included in this review. The technique is unanimously reported to be feasible and safe, but the available studies are characterized by considerable heterogeneity and bias.

Conclusions. Uniform reported outcome measures are needed to draw more definitive conclusions on transplant outcomes and organ utilization. A randomized controlled trial comparing aNRP with standard procurement technique in donation after circulatory death donors would be needed to show the added value of the procedure and determine its place among modern preservation techniques.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1097/tp.0000000000003345

Authors



Publisher:
Lippincott, Williams & Wilkins
Journal:
Transplantation More from this journal
Volume:
104
Issue:
9
Pages:
1776-1791
Publication date:
2020-06-09
Acceptance date:
2020-05-15
DOI:
EISSN:
1534-6080
ISSN:
0041-1337
Pmid:
32541563


Language:
English
Keywords:
Pubs id:
1112766
Local pid:
pubs:1112766
Deposit date:
2020-10-13

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