Direct Procurement of Thoracic Organs Along with Abdominal Normothermic Regional Perfusion in Donation After Circulatory Death

PurposeDirect procurement of thoracic organs as compared to using abdominal normothermic regional perfusion (aNRP) is the preferred method for organ in donors after circulatory death (DCD). The use aNRP improves outcomes from liver transplantation. We have developed a technique isolation during that allows successful co-procurement and organs.MethodsIn order achieve both brain volume loss must be prevented. After certification standoff period thoraco-abdominal incision performed. Blood collected donor right atrium or side-arm circuit prime care system (OCS) before vascular structures systematic way. 1. left pleura opened, lung retracted allow identification clamping descending aorta above diaphragm. 2. ascending clamped, aortic arch vented cranial clamp. Abdominal NRP can then commence. 3. inferior vena-cava clamped within pericardium. 4. superior azygos vein are tied off. 5. heart on side induction cardioplegia. diagram illustrates complete cavity enabling explantation delivery selective antegrade pneumoplegia while continue perfused 2-hours start procurement.ResultsBetween 2019-21 we successfully performed seven such procurements. Three lungs, three lungs one alone. All were implanted with immediate outcome all recipients.ConclusionDirect feasible option aNRP. This will potentially expand pool improve Direct organs. In procurement. Between recipients.