P.136: Heart transplantation following medically assisted dying using ex-vivo normothermic machine perfusion.

作者：Michael J. O’Leary, Yashutosh Joshi, Kelly Lewis, Rodrigo Fritis-Lamora, Claudio Soto, Peter S. Macdonald · 发表于：Transplantation · 年份：2024 · DOI：10.1097/01.tp.0001067400.25704.a0 · 被引用次数：1 · 研究领域：Transplantation: Methods and Outcomes、Organ Transplantation Techniques and Outcomes、Renal Transplantation Outcomes and Treatments

Introduction: Patients with terminal illness electing for medically assisted dying (MAD) have the potential to donate organs following circulatory death. Successful heart procurement and transplantation after in-vivo cardiac reanimation using thoraco-abdominal normothermic regional perfusion (NRP) has been reported. NRP is associated with ethical concerns and may not be legal in some jurisdictions. We report the successful procurement and transplantation of a heart from a patient after MAD, with ex-vivo cardiac reanimation using normothermic machine perfusion (NMP). Methods: A 45-year-old male with a 2-year history of glioblastoma multiforme, WHO grade 4, and no other significant past medical history, was approved for MAD given short life expectancy and deteriorating functional status. He expressed a wish to donate his organs after death. He was admitted to hospital on his chosen date for MAD. In the anaesthetic bay of an operating theatre (OT) with his family in attendance, Heparin 55,000 units was administered two minutes prior to medications for MAD. Death was determined 5mins after electrical asystole on ECG, 19mins following administration of medications. The donor was transferred to the OT and the heart retrieved using a direct procurement protocol. Total asystolic warm ischaemic time prior to administration of cardioplegia was 10mins. Back-table cold ischaemic time was 32mins. The heart was perfused on the NMP device for 217mins. Donor heart viability was assessed usin...