Donation after circulatory determination of death: the university of michigan experience with extracorporeal support.
BACKGROUND
Extracorporeal support (ECS) during organ procurement from donors after circulatory determination of death (DCDD) could increase the number of donor organs and decrease posttransplant complications. This study reports the experience of a large transplant center with controlled DCDD.


METHODS
A retrospective review of all potential controlled-DCDD cases between October 1, 2000 and July 31, 2013 was performed. We focused on methods, ethical and practical issues, and recipient outcome data of organs procured and transplanted in our institution using ECS-assisted DCDD (E-DCDD).


RESULTS
ECS was used for organ procurement in 37 controlled DCDD. The number of organs procured per donor was 2.59, and the number of organs transplanted per donor was 1.68. Delayed graft function occurred in 31% of renal grafts. In three donors (8%), organ donation was not completed because of surgeon judgment. Forty-eight renal grafts (65.8%), thirteen livers (61.9%), and one pancreas (50%) were successfully transplanted.


CONCLUSIONS
ECS can be routinely implemented in controlled DCDD. In our experience, the organs provided per donor was 2.59. Widely applied, EDCDD could result in more donor organs, especially when applied to DCDD in uncontrolled conditions.
1 Department of Surgery, University of Michigan, Ann Arbor, MI. 2 Address correspondence to: Alvaro Rojas-Peña, M.D., University of Michigan ECLS Laboratory, 1150 W. Medical Center Drive, B560 MSRBII, Ann Arbor, MI 48109.
Alvaro
A
Rojas-Peña
Lauren E
LE
Sall
Mark T
MT
Gravel
Elaine G
EG
Cooley
Shawn J
SJ
Pelletier
Robert H
RH
Bartlett
Jeffrey D
JD
Punch
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003643:Death; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement