Novel Donor Transfer Algorithm for Multiorgan and Facial Allograft Procurement

Diaz-Siso, J. Rodrigo; Plana, Natalie M.; Schleich, B; Irving, Helen; Gelb, Bruce; Rodriguez, Eduardo D.

doi:10.1111/ajt.14380

Cited by 10 publications

(10 citation statements)

References 5 publications

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“…Table 8 summarizes the anesthetic considerations in FT based on our institutional experience and supported by representative references from the literature review. 1 , 2 , 4 , 5 , 11 , 16 – 21 , 24 – 27 , 30 – 40 , 42 , 44 – 92 These are elaborated on in the narrative synthesis summarized in the Discussion section of this article.…”

Section: Resultsmentioning

confidence: 99%

“… 44 , 46 , 63 , 64 Donor selection and preparation must occur within a certain distance from the FT center to control for ischemia time; this highlights the importance of sufficiently stabilizing the donor for travel and controlling for transit-associated risks. 21 , 47 , 52 To date, facial allograft donors have all been sex matched, and ages have ranged from 18 to 65 years. 33 , 65 …”

Section: Discussionmentioning

confidence: 99%

“…An institutional “FT Anesthesia Protocol,” including a donor transfer algorithm, was developed. 21 Cadaveric simulations and a research procurement were performed to educate team members and plan procedures. 3 , 4 …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Anesthetic Considerations in Facial Transplantation: Experience at NYU Langone Health and Systematic Review

Alfonso

Ramly

Kantar

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Anesthetic considerations are integral to the success of facial transplantation (FT), yet limited evidence exists to guide quality improvement. This study presents an institutional anesthesia protocol, defines reported anesthetic considerations, and provides a comprehensive update to inform future directions of the field. Methods: An institutional “FT Anesthesia Protocol” was developed and applied to 2 face transplants. A systematic review of 3 databases captured FTs in the peer-reviewed literature up to February 2020. Two reviewers independently screened titles and abstracts to include all clinical articles with FT recipient and/or donor-specific preoperative, intraoperative, and relevant postoperative anesthetic variables. Data charting guided a narrative synthesis, and quantitative synthesis reported variables as median (range). Results: Our institutional experience emphasizes the importance of on-site rehearsals, anticipation of patient-specific anesthetic and resuscitative requirements, and long-term pain management. Systematic search identified 1092 unique records, and 129 met inclusion criteria. Reports of 37 FTs in the literature informed the following anesthetic axes: donor pre- and intraoperative management during facial allograft procurement, recipient perioperative care, immunotherapy, antimicrobial prophylaxis, and pain management. Quantitative synthesis of 30 articles showed a median operative time of 18 hours (range, 9–28) and fluid replacement with 13 L (5–18) of crystalloids, 13 units (0–66) of packed red blood cells, 10 units (0–63) of fresh frozen plasma, and 1 unit (0–9) of platelets. Conclusions: Anesthetic considerations in FT span the continuum of care. Future efforts should guide standard reporting to establish evidence-based strategies that promote quality improvement and patient safety.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anesthetic Considerations in Facial Transplantation: Experience at NYU Langone Health and Systematic Review

Alfonso

Ramly

Kantar

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…Criterios de selección de donante y receptor 1.1.1 Donante Se toma en consideración pacientes con muerte cerebral, sin patologías cardíacas y con características similares al receptor como: edad, sexo, talla, peso, color de piel, color de cabello, dimensiones craneofaciales y grupo sanguíneo ABO idéntico 1, 3,13 . Es importante el desarrollo de un algoritmo logístico para la adquisición de tejidos de un donante como el propuesto por "The New York University"; donde se prioriza la seguridad del equipo quirúrgico, la integridad del órgano sólido y el tiempo de isquemia reducido del aloinjerto facial 16 .…”

Section: Metodología De Búsquedaunclassified

Trasplante facial generalidades

Cárdenas¹,

Fernández²,

Arteaga³

et al. 2020

Rev Medicas UIS

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El trasplante facial es un alotrasplante compuesto vascularizado que busca la reconstrucción de defectos masivos faciales permitiendo la reinserción social del receptor, generando un impacto positivo sobre su calidad de vida. El objetivo de este artículo fue realizar una revisión de la literatura sobre generalidades del trasplante facial, enfocándose en los cuidados pre, intra y postoperatorios concernientes a la temática. La búsqueda bibliográfica se realizó desde el 13 de septiembre del 2018 hasta el 31 de marzo del 2019 utilizando los términos MESH “Face Transplant” y “Face Transplantation”. Aplicando los criterios de inclusión y exclusión se obtuvieron 43 artículos sobre los cuales se desarrolló la revisión. El trasplante facial es un procedimiento nuevo en el cual hay muchas áreas por explorar, sin embargo, es una alternativa prometedora a los métodos utilizados para la reconstrucción de lesiones faciales complejas, que se optimizará a medida que se extienda su uso.

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“…Standardization of logistical processes that are critical to FT was implemented, including an algorithm for asynchronous face and multiorgan allograft procurement from brain dead donors 4 and an algorithm for the safe transfer of multiorgan donors to the FT team’s home institution in collaboration with the local organ procurement organization. 4 These algorithms focus on ensuring the integrity of lifesaving solid organ allografts, enhancing surgical team safety, and improving communication between donor and recipient teams. Finally, perioperative nursing workflows have been developed in our most recent series of FT simulations.…”

Section: Workflow Standardizationmentioning

confidence: 99%