title: Outcome of organs procured from donors on extracorporeal membrane oxygenation support: an analysis of kidney and liver allograft data.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation has become rescue therapy for adults with overwhelming cardiac and/or respiratory failure. Not all patients are saved, creating a new cohort of potential organ donors. This study examines the outcomes of liver and kidney allografts procured from donors on extracorporeal membrane oxygenation (ECMO).
  
  
  METHODS
  A retrospective review was conducted through the local organ procurement organization. Donors on ECMO prior to notification were classified into donation after brain death (DBD) and donation after cardiac death (DCD). We compared short-term outcome data against published standards.
  
  
  RESULTS
  Between 1995 and 2012, 97 organs were procured from 41 donors supported on ECMO. There were 68 kidneys donated, 51 were transplanted and 17 discarded. Excluding extended criteria donors, 29 DBD and 13 DCD kidneys were transplanted from donors supported on ECMO. Delayed graft function occurred in 34% of DBD kidneys and 38% of DCD kidneys. Kidney allograft survival at one yr was 93%. Twenty-four livers were procured, nine discarded, and 15 transplanted. Ninety-three percent of liver transplant recipients were alive with graft function at one yr.
  
  
  CONCLUSIONS
  Donation after brain death kidneys procured from donors on ECMO perform similarly to non-ECMO organs with regard to delayed graft function (DGF), one-yr graft survival and function. Livers from ECMO donors have a higher discard rate than non-ECMO donors, but function similarly at six months and one yr.
authors.forename: Timothy
authors.initials: T
authors.lastname: Carter
authors.affiliation: Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Bodzin
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirose
authors.forename: Sharon
authors.initials: S
authors.lastname: West
authors.forename: Richard
authors.initials: R
authors.lastname: Hasz
authors.forename: Warren R
authors.initials: WR
authors.lastname: Maley
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Cavarocchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D001926:Brain Death; D002648:Child; D002675:Child, Preschool; D051799:Delayed Graft Function; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: donor classification; extracorporeal membrane oxygenation; organ donation; outcomes; solid organ transplantation