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In situ liver splitting under extracorporeal membrane oxygenation in brain-dead donor


Assalino, Michela; Majno, Pietro; Toso, Christian; Berney, Thierry; Giraud, Raphaël; Dutkowski, Philipp; Andres, Axel; Wildhaber, Barbara; Elkrief, Laure (2017). In situ liver splitting under extracorporeal membrane oxygenation in brain-dead donor. American Journal of Transplantation, 18(1):258-261.

Abstract

Hemodynamic instability is generally considered as a contraindication to liver splitting, in particular when using an in situ technique. We describe the cases of two young donors with brain death in whom refractory cardiac arrest and hemodynamic instability were supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), allowing uneventful in situ splitting. Two adult and two pediatric liver recipients were successfully transplanted with immediate graft function. Favorable outcomes were also observed for the other transplanted organs, including one heart, two lungs, and four kidneys. Refractory cardiac arrest and hemodynamic instability corrected by VA-ECMO should not be considered as a contraindication to in situ liver splitting.

Abstract

Hemodynamic instability is generally considered as a contraindication to liver splitting, in particular when using an in situ technique. We describe the cases of two young donors with brain death in whom refractory cardiac arrest and hemodynamic instability were supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), allowing uneventful in situ splitting. Two adult and two pediatric liver recipients were successfully transplanted with immediate graft function. Favorable outcomes were also observed for the other transplanted organs, including one heart, two lungs, and four kidneys. Refractory cardiac arrest and hemodynamic instability corrected by VA-ECMO should not be considered as a contraindication to in situ liver splitting.

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Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2017
Deposited On:09 Feb 2018 17:26
Last Modified:19 Aug 2018 14:05
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1600-6135
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/ajt.14461
PubMed ID:28801937
Project Information:
  • : FunderSNSF
  • : Grant IDPP00P3_139021
  • : Project TitleAdjuvant management after liver transplantation for hepatocellular carcinoma

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