En Bloc Heart and Lung Rapid Recovery Combined With Abdominal Normothermic Regional Perfusion Donation After Circulatory Death

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The en bloc heart and lung donation after circulatory death (DCD) rapid recovery protocol, particularly when combined with abdominal normothermic regional perfusion (A-NRP), has been demonstrated to be safe and feasible. Key steps include isolating the chest cavity from the abdomen by clamping the thoracic aorta and inferior vena cava (IVC) and controlling bleeding through ligation of the azygos vein, head vessels, superior vena cava (SVC), and innominate veins. When splitting the atrial and pulmonary cuffs at the back table, excellent visualization allows for precise cuts to prevent compromised margins. This technique enables prompt organ retrieval while reducing bleeding, thereby optimizing organ quality and preservation. Its implementation offers a promising strategy to expand the donor pool and enhance transplantation outcomes. 

References

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