Single lung retrieval from a donor supported by a left ventricular assist device

Abstract

The number of patients who need cardiac support with a left ventricular assist device (LVAD) has increased over the last decade. However, the number of reports of organ retrieval from donors with an LVAD is still small. Successful lung retrieval for single lung transplantation was performed from a donor on LVAD support. This required special care not to injure the heart, great vessels, and the device, particularly the outflow conduit, because of significant conglutination around the device. A right single lung transplantation was performed successfully, with no postoperative complications. This means that patients on an LVAD could be potential donors for lung transplantation.

Multiple organ retrieval in a brain dead left ventricular assist device donor

“…The number of reports describing organ retrieval from donors with LVADs is still small [1][2][3][4][5].…”

“…Despite the current adoption of newer continuous-flow pumps, LVAD recipients are still exposed to risks of infectious and neurological adverse events [8]. As such patients appreciate the need for donor organs at the time of their LVAD implantation, they themselves are usually willing to be donors if they themselves become brain dead [1,4].…”

“…The suitability of patients with LVADs for organ donation has not been addressed in terms of guidelines [1,4]. Considering prior cardiac failure and cardiac surgery, it is a relative contraindication [1][2][3][4][5]. However, after LVAD implantation, all systemic organs could be kept stable.…”

“…However, after LVAD implantation, all systemic organs could be kept stable. Thus, if organ damage from severe heart failure can be avoided, patients with an LVAD can be organ donors even if considered marginal [1][2][3][4][5].…”

“…Left ventricular assist device (LVAD) support in donors may contribute in preserving proper haemodynamics and systemic perfusion during organ retrieval thus decreasing the risk of multiple organ injury. This is an option to expand the current organ supply [1][2][3][4][5].…”