Application of fast perfusion through abdominal aorta and portal vein in combined liver and kidney procurement from organ donation

  Objective  To summarize the feasibility and safety of fast perfusion through abdominal aorta and portal vein in combined liver and kidney procurement from organ donation.

  Methods  Clinical data of 43 donors of donation after cardiac death (DCD) undergoing combined liver and kidney procurement in the First People's Hospital of Foshan from September 2011 to June 2014 were analyzed retrospectively. Among the 43 donors, 15 cases were China DCD donor category Ⅰ(donor after brain death)(C-Ⅰ), 1 case was category Ⅱ (donor after cardiac death)(C-Ⅱ) and 27 cases were category Ⅲ (C-Ⅲ). Combined abdominal aorta and portal vein perfusion with fast cannulation were performed.

  Results  The time from abdomen incision to abdominal aorta cannulation was 1.5-2.0 min. Forty-three livers and eighty-six kidneys were procured from 43 donors. The warm ischemia time (WIT) was 0 for C-Ⅰ donors, and was 3-21 min for the other donors (mean:10 min). Two liver grafts were discarded for major injury of the porta hepatis and severe fatty liver respectively. Eighteen kidney grafts were discarded for kidney stones, kidney atrophy, high level of preoperative serum creatinine, severe renal atherosclerosis, renal microvessel thrombosis, multiple renal cyst, kidney traumatic rupture, etc. The total discard rate of donor organs was 16%.

  Conclusions  Fast perfusion through abdominal aorta and portal vein is a simple and safe method in combined procurement liver and kidney from organ donation.