Multiple organ harvesting from a single donor for transplantation. A comparison of simple cooling technique and bypass technique.

BACKGROUND

We compared a simple, cooling technique to a cardiopulmonary bypass (CPB) technique for multiple organ harvesting (MOH) from a single donor.

METHODS

Adult mongrel dogs were divided into three groups. In the in situ cooling group, the aorta and IVC were first clamped and the hepatic and renal vascular beds were washed out with a cold lactated Ringer's solution. In the peritoneal cooling group, hypothermia was induced using an ice slush in the abdominal cavity, and in the CPB group using CPB. As the esophageal temperature reached 25 degrees C, the liver and kidneys were harvested using the same procedure in all three groups. After the splanchnic perfusion, the heart was harvested while it continued to beat. The heart was preserved for 12 hours, and the liver and kidneys for 24 hours in a cold UW solution. Myocardial high-energy phosphates were measured using 31P-MRS, and the hearts were transplanted. Hepatic vascular beds were flushed during preservation, and the effluent was analyzed. Following kidney transplantation, its function was measured.

RESULTS

There's no significant difference in myocardial high-energy phosphate or in cardiac function after transplantation. During liver preservation, ALT and LDH levels of the effluent were significantly higher in the in situ group than those in other groups. There's no difference following kidney transplantation.

CONCLUSION

The CPB method and peritoneal cooling technique demonstrated stronger early function of hepatic grafts compared with the in situ cooling method. The peritoneal cooling technique is a simpler, safer and more feasible alternative for MOH compared with CPB method, and it may have broad clinical application.