Toggle Main Menu Toggle Search

Open Access padlockePrints

The effect of inadequate in situ perfusion in the non heart-beating donor

Lookup NU author(s): Muhammed Gok, John Asher, Ajay Gupta, Dr Brian Shenton, Dr Helen Robertson, Professor Naeem Soomro, David Talbot


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


In situ aortic perfusion in the nonheart-beating donors (NHBD) is an important procedure to reduce primary warm ischaemic injury prior to formal donor organ retrieval. It allows an interim period to obtain donor family consent and theatre preparation. This study describes our experience of inadequate aortic perfusions resulting from difficult aortic cannulations and associated adverse outcome despite reasonable viability tests. Since 1998, all NHBD in our institution are perfused in situ using a double balloon triple lumen (DBTL) catheter inserted through a femoral artery cut-down procedure. The DBTL catheter is positioned with distal occlusive balloon at the aortic bifurcation using the 'pull-back' technique, the proximal occlusive balloon lies above the renal arteries. This provides selective aortic perfusion in particular the kidneys. Venous decompression using a femoral vein catheter enables a 'two-way infusion system'. Pre-transplant viability status of retrieved kidneys is determined by measuring pressure/resistance characteristics to the flow and biochemical markers for ischaemic injury. There were 90 NHBD renal transplants performed from 72 donors. Three renal transplants were carried out from three donors of ineffective in situ perfusion secondary to cannulation difficulties. Femoral cannulation was difficult as a result of extensive atherosclerosis of donor vessels. The comparison of allograft outcome from effective and ineffective in situ perfusion of donors showed high rate of primary nonfunction (PNF) from ineffective perfusion (chi-squared, P < 0.0001). The cases demonstrated poor outcome from ineffective perfusion related to the cannulation difficulties. Therefore a strict policy should be taken in cases where aortic cannulation and perfusion is inadequate, despite pretransplant assessment. In these circumstances, the primary warm ischaemia time should be extended to include this period of ineffective perfusion. © 2005 European Society for Organ Transplantation.

Publication metadata

Author(s): Gok, M.A., Bhatti, A., Asher, J., Gupta, A., Shenton, B.K., Robertson, H., Soomro, N., Talbot,D.

Publication type: Article

Publication status: Published

Journal: Transplant International

Year: 2005

Volume: 18

Issue: 10

Pages: 1142-1146

Print publication date: 01/10/2005

ISSN (print): 0934-0874

ISSN (electronic): 1432-2277


DOI: 10.1111/j.1432-2277.2005.00164.x

PubMed id: 16162100


Altmetrics provided by Altmetric