Pratiques anesthésiques pour prélèvement d’organes chez le sujet en mort encéphalique et pronostic du greffon rénal

Boutin, C; Vachiéry-Lahaye, Florence; Alonso, Sandrine; Louart, Guillaume; Bouju, Agnès; Lazarovici, Sonia; Perrigault, Pierre François; Capdevila, Xavier; Jaber, Samir; Colson, P; Jonquet, O.; Ripart, Jacques; Lefrant, JY; Muller, Laurent; AzuRéa, pour le groupe

doi:10.1016/j.annfar.2011.11.027

Cited by 6 publications

(1 citation statement)

References 72 publications

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“…An alternative approach for assessing perioperative bleeding during a MOPP involves the utilization of blood products, including red cell units and other derived components. Within a French multicentric DBDD cohort study, it was observed that approximately 15 to 30% of procedures necessitated the administration of red blood cell units, plasma and platelets to manage per-operative anemia [101]. This approach lacks precision, as transfusion of red blood units primarily addresses anemia to enhance oxygen transport and does not serve as a distinct indicator of significant bleeding events.…”

Section: Association With the Multi-organ Procurement Procedures (Mopp)mentioning

confidence: 99%

Tissue Injury Protection: The Other Face of Anticoagulant Treatments in the Context of Ischemia and Reperfusion Injury with a Focus on Transplantation

Carré,

Kerforne,

Hauet

et al. 2023

IJMS

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Organ transplantation has enhanced the length and quality of life of patients suffering from life-threatening organ failure. Donors deceased after brain death (DBDDs) have been a primary source of organs for transplantation for a long time, but the need to find new strategies to face organ shortages has led to the broadening of the criteria for selecting DBDDs and advancing utilization of donors deceased after circulatory death. These new sources of organs come with an elevated risk of procuring organs of suboptimal quality. Whatever the source of organs for transplant, one constant issue is the occurrence of ischemia–reperfusion (IR) injury. The latter results from the variation of oxygen supply during the sequence of ischemia and reperfusion, from organ procurement to the restoration of blood circulation, triggering many deleterious interdependent processes involving biochemical, immune, vascular and coagulation systems. In this review, we focus on the roles of thrombo-inflammation and coagulation as part of IR injury, and we give an overview of the state of the art and perspectives on anticoagulant therapies in the field of transplantation, discussing benefits and risks and proposing a strategic guide to their use during transplantation procedures.

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Section: Association With the Multi-organ Procurement Procedures (Mopp)mentioning

confidence: 99%

Tissue Injury Protection: The Other Face of Anticoagulant Treatments in the Context of Ischemia and Reperfusion Injury with a Focus on Transplantation

Carré,

Kerforne,

Hauet

et al. 2023

IJMS

View full text Add to dashboard Cite

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Anesthetic Management of Brain-dead Adult and Pediatric Organ Donors: The Harborview Medical Center Experience

Lele

Nair

Fong

et al. 2020

Journal of Neurosurgical Anesthesiology

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Introduction:The exposure of anesthesiologists to organ recovery procedures and the anesthetic technique used during organ recovery has not been systematically studied in the United States.Methods: A retrospective cohort study was conducted on all adult and pediatric patients who were declared brain dead between January 1, 2008, and June 30, 2019, and who progressed to organ donation at Harborview Medical Center. We describe the frequency of directing anesthetic care by attending anesthesiologists, anesthetic technique, and donor management targets during organ recovery.Results: In a cohort of 327 patients (286 adults and 41 children), the most common cause of brain death was traumatic brain injury (51.1%). Kidneys (94.4%) and liver (87.4%) were the most common organs recovered. On average, each year, an attending anesthesiologist cared for 1 (range: 1 to 7) brain-dead donor during organ retrieval. The average anesthetic time was 127 ± 53.5 (mean ± SD) minutes. Overall, 90% of patients received a neuromuscular blocker, 63.3% an inhaled anesthetic, and 33.9% an opioid. Donor management targets were achieved as follows: mean arterial pressure ≥ 70 mm Hg (93%), normothermia (96%), normoglycemia (84%), urine output > 1 to 3 mL/kg/h (61%), and lung-protective ventilation (58%).Conclusions: During organ recovery from brain-dead organ donors, anesthesiologists commonly administer neuromuscular blockers, inhaled anesthetics, and opioids, and strive to achieve donor management targets. While infrequently being exposed to these cases, it is expected that all anesthesiologists be cognizant of the physiological perturbations in brain-dead donors and achieve physiological targets to preserve end-organ function. These findings warrant further examination in a larger multiinstitutional cohort.

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Better liver transplant outcomes by donor interventions?

Hessheimer,

Flores,

Vengohechea

et al. 2024

Current Opinion in Organ Transplantation

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Purpose of review Donor risk factors and events surrounding donation impact the quantity and quality of grafts generated to meet liver transplant waitlist demands. Donor interventions represent an opportunity to mitigate injury and risk factors within donors themselves. The purpose of this review is to describe issues to address among donation after brain death, donation after circulatory determination of death, and living donors directly, for the sake of optimizing relevant outcomes among donors and recipients. Recent findings Studies on donor management practices and high-level evidence supporting specific interventions are scarce. Nonetheless, for donation after brain death (DBD), critical care principles are employed to correct cardiocirculatory compromise, impaired tissue oxygenation and perfusion, and neurohormonal deficits. As well, certain treatments as well as marginally prolonging duration of brain death among otherwise stable donors may help improve posttransplant outcomes. In donation after circulatory determination of death (DCD), interventions are performed to limit warm ischemia and reverse its adverse effects. Finally, dietary and exercise programs have improved donation outcomes for both standard as well as overweight living donor (LD) candidates, while minimally invasive surgical techniques may offer improved outcomes among LD themselves. Summary Donor interventions represent means to improve liver transplant yield and outcomes of liver donors and grafts.

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Pratiques anesthésiques pour prélèvement d’organes chez le sujet en mort encéphalique et pronostic du greffon rénal

Cited by 6 publications

References 72 publications

Tissue Injury Protection: The Other Face of Anticoagulant Treatments in the Context of Ischemia and Reperfusion Injury with a Focus on Transplantation

Tissue Injury Protection: The Other Face of Anticoagulant Treatments in the Context of Ischemia and Reperfusion Injury with a Focus on Transplantation

Anesthetic Management of Brain-dead Adult and Pediatric Organ Donors: The Harborview Medical Center Experience

Better liver transplant outcomes by donor interventions?

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