EISOR Delivery: Regional experience with sharing equipe, equipment & expertise to increase cDCD donor pool in time of pandemic

Perfusion. 2024 Jan;39(1):85-95. doi: 10.1177/02676591221103535. Epub 2022 May 28.

Abstract

Donation after circulatory death (DCD) programs are expanding in Europe, in the attempt to expand donors pool. Even in controlled DCD donors, however, a protracted warm ischemia time occurring in the perimortem period might damage organs, making these unsuitable for transplantation. Implementing a strategy of extracorporeal interval support for organ retrieval (EISOR), a regional reperfusion with normothermic, oxygenated blood provides a physiologic environment allowing extensive assessment of potential grafts, and potentially promotes recovery of native function. Here we report the results of a multi-center retrospective cohort study including 29 Maastricht Category III controlled DCD donors undergoing extracorporeal support in a regional DCD/EISOR Training Center, and in the network of referring In-Training Centers, under the liaison of the regional Transplant Coordination Center during COVID-19 pandemic, between March 2020 and November 2021. The study aims to understand whether a mobile, experienced EISOR team implementing a consistent technique and sharing its equipe, expertise and equipment in a regional network of hospitals, might be effective and efficient in implementing the regional DCD program activity even in a highly stressed healthcare system.

Keywords: donation after circulatory death; extracorporeal interval support for organ retrieval; normothermic regional perfusion; organ donation; organ donor; transplantation.

MeSH terms

  • Graft Survival
  • Humans
  • Organ Preservation / methods
  • Pandemics*
  • Perfusion / methods
  • Retrospective Studies
  • Tissue Donors
  • Tissue and Organ Harvesting
  • Tissue and Organ Procurement*