Effect of multiorgan donation after cardiac death retrieval on lung performance

Aim: For donation after cardiac death (DCD) transplantation to achieve its full potential, multiorgan retrieval is desirable. Although there are several novel individual techniques recently described for DCD lung donation, they have not been evaluated or compared in a DCD multiorgan scenario. Description: This study describes (i) the technical aspects and (ii) early lung and abdominal organ performance of several combinations of DCD donor liver, kidney and lung retrieval techniques that would mimic common DCD clinical scenarios. Evaluation: Lung oxygenation, urine production, bile production and biochemical measures were assessed as the outcome of a complex ex vivo lung, liver and kidney perfusion DCD model. Conclusion: Successful ex vivo multiorgan perfusion was possible following the three retrieval techniques tested, with excellent oxygenation over a 2-h assessment period, identical to prior studies where the lungs were tested alone. Multiorgan DCD retrieval, including lungs of good quality, is possible from a variety of clinical scenarios and should therefore be considered with all DCD retrieval opportunities.