International Perfusion Association


Category: Transplantation


Alternative Venous Access Sites for Dual-Lumen Extracorporeal Membrane Oxygenation Cannulation

This multicenter case series examines the safety and feasibility of using alternative venous access sites for dual-lumen cannulas in veno-venous (VV) extracorporeal membrane oxygenation (ECMO) when the right internal jugular vein (RIJV) is inaccessible. Data from three high-volume ECMO centers were analyzed, involving 20 patients who required alternative access due to inaccessible RIJV. The study found no procedural complications with alternative sites, which included the left internal jugular, subclavian, and femoral veins. The outcomes were promising with half of the patients successfully bridged to lung transplantation or recovery, highlighting the viability of these alternative sites for critical ECMO support.

TP Perfusion

Beating Heart Transplant Procedures Using Organs From Donors With Circulatory Death

This study evaluates the safety and efficacy of the beating heart method for heart transplantation using donors deceased after circulatory death (DCD). Conducted on 10 male patients with end-stage heart failure, it found 100% survival without the need for postoperative extracorporeal membrane oxygenation (ECMO). This method, which potentially reduces ischemia reperfusion injury, suggests a promising approach to DCD heart transplantation that may lower the incidence of primary graft dysfunction. The findings are significant for institutions considering the use of DCD donors for heart transplants.

Lung Transplat

Intraoperative Extracorporeal Support during Lung Transplantation: Not Just for the High-Risk Patient

In lung transplantation, the use of intraoperative mechanical support, particularly cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), has evolved over time due to their respective advantages and disadvantages. While CPB was traditionally preferred for its full hemodynamic support, it poses risks like systemic inflammation and coagulopathy; ECMO, on the other hand, offers many benefits of CPB with fewer risks, leading to better outcomes such as reduced primary graft dysfunction and overall improved survival, suggesting its potential as a standard protocol in lung transplants.

Heart Transplantation

Donor Heart Preservation: Current Knowledge and the New Era of Machine Perfusion

Heart transplantation traditionally employs static cold storage for donor preservation, but this method carries a risk of early graft dysfunction due to ischemic and reperfusion injury. Emerging preservation techniques, such as hypothermic or normothermic machine perfusion, offer the promise of improved graft protection, the ability to repair organs, and the evaluation of graft function prior to transplantation, potentially expanding the donor pool with the aid of new pharmacological treatments.


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