ESTABLISHMENT OF MULTIORGAN PROCUREMENT SYSTEM FROM NO-HEART-BEATING DONOR USING PERCUTANEOUS CARDIOPULMONARY BYPASS

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Donor shortage is one of the most serious problem in organ transplantation (Tx). Use of non-heart-beating donors may extremely expand donor pools. In this study, the method of reanimation of multiple organs in non-heart-beating donor by percutaneous cardiopulmonary support (PCPS) was evaluated.Methods : 13 beagle dogs were asphyxiated with pancronium bromide and cessation of respiratory support after giving prostacyclin, verapamil, propranolol and nafmostat mesilate, intravenously. After leaving organs for 30 minutes in the dead body, the body was reperfused by PCPS for 1 hour with the priming fluid including four drugs shown above and KCl. Heart Tx (HTx) : 8 heart was preserved in UW solution for 24 hours and transplanted orthotopically with using terminal leukocyte-depleted blood cardioplegia Single lung Tx (LTx) : 5 left lung were transplanted orthotopically. Renal Tx (RTx) : 3 kidneys were transplanted heterotopically in the groin.Results : All donor hearts stopped within 20 minutes after asphyxia without ventricular fibrillation. HTx : All grafts beated spontaneously and all animals was weaned from cardiopulmonary bypass without using catecholamine. LTx : The O2 pressure and CO2 pressure of pulmonary vein blood of donor lung were not different from those of the recipient (control) lung. All animals could survived until the lung was rejected.RTx : All transplanted kidney make urine soon after reperfusion with more than 1 ml/Kg of output.Conclusions : These data suggested that hearts, lungs and kidneys from non-heart-beating donor which were pretreated with four drugs and reanimated with PCPS be transplanted successfully and that this method may expand donor pool.