Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor

Abstract

We report on the to date largest recovery of eleven organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants (VCA) and tissues. Our experience of 8 additional successful multiple VCA, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.

The First Successful Combined Full Face and Bilateral Hand Transplant

“…Previous studies have confirmed the viability of solid organs procured alongside face and hand allografts from the same donor. 37 To minimize vascularized composite allotransplantation allograft ischemia time given the complexity of the planned combined transplant, we elected to proceed with face and hand before solid organ procurement. Every effort was made to allocate all suitable organs ( see Figure, Supplemental Digital Content 7 , http://links.lww.com/PRS/F239).…”

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

“… 30 , 33 , 67 , 83 The feasibility and safety of beginning facial dissection before solid organ procurement have been extensively demonstrated with no negative implications on the outcomes of solid organ transplants. 44 , 50 , 67 , 68 …”

“… 4 , 53 Despite these challenges, meticulous planning has resulted in successful recovery of up to 11 organs and tissues from a single donor. 68 Donor facial integrity is restored with a silicone-based or, more recently, a 3-dimensionally printed mask, eliminating the need for an invasive impression procedure. 69 – 71 …”

Eponychial lesions following bilateral upper extremity vascular composite allotransplantation: a case report

“…In October 2014, a suitable match was identified and the patient underwent bilateral upper extremity VCAs. The family of the donor denied any social behaviour of increased risk, and all standard serology assessment, including nucleic acid testing, was negative for viral infection, except for EBV-IgG [ 4 ]. Induction of immunosuppression included thymoglobulin 1.5 mg/kg.…”