title: Logistics and strategy of multiorgan procurement involving total face allograft.
abstract: The face is the latest body structure to be added to the field of transplantation and the learning curve is ongoing. In the scenario of multiorgan recovery, the face is a nonvital 'organ' structure compared with other life-saving organs. To date, the face has been the first 'organ' to be procured in a multiorgan procurement. A technique for simultaneous recovery of the whole face, heart, lungs, liver, pancreas and kidneys is described. Thirty professionals participated in the procedure, of whom 13 were surgeons. No tracheotomy was performed. A mask of the donor's face was made from a mold impression. Duration of the procedure from skin incision to the end of surgery was 7.3 h. The face was perfused with Wisconsin solution through a cannula inserted into the aortic arch between the origin of the brachiocephalic arterial trunk and the left subclavian artery. Blood requirements consisted of 4 units of packed red blood cells. After the procedure, the mask was placed on the donor's face. All recovered grafts functioned immediately. In summary, simultaneous multiorgan procurement including the whole face is feasible, effective and saves time without jeopardizing life-saving organs and without the need for tracheotomy.
authors: Pediatric Liver Transplantation Unit, Hospital Universitario Valle de Hebron, Autonomous University of Barcelona, Barcelona, Spain. jbueno@vhebron.net
authors: J
authors: J
authors: Bueno
authors: J P
authors: JP
authors: Barret
authors: J
authors: J
authors: Serracanta
authors: A
authors: A
authors: Arnó
authors: J M
authors: JM
authors: Collado
authors: C
authors: C
authors: Valles
authors: M J
authors: MJ
authors: Colominas
authors: Y
authors: Y
authors: Diez
authors: T
authors: T
authors: Pont
authors: P
authors: P
authors: Salamero
authors: V
authors: V
authors: Martinez-Ibañez
mesh_terms: D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D005145:Face; D054445:Facial Transplantation / Q000295:instrumentation / Q000379:methods*; D005978:Glutathione; D006439:Hemodynamics; D006801:Humans; D007328:Insulin; D008297:Male; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions; D016377:Organ Transplantation / Q000379:methods; D010477:Perfusion; D011887:Raffinose; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods
chemical_list: D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose