Complications during multiorgan retrieval and pancreas preservation

• 作者: Daniel Casanova Federico Castillo Gonzalo Gutierrez Monica Gonzalez Noriega
• 来源期刊: 世界移植杂志
• 学科: 医学
• 关键词: Pancreas transplantation Diabetes mellitus Graft thrombosis Compartmental syndrome Pancreas retrieval Pancreas preservation
• 年，卷（期）: 2020,（12）
• 页码范围: 381-391
• 页数: 11页
• 分类号: R73

摘要

In pancreas transplantation, complications can arise at each step of the process,from the initial selection of donors and recipients through the surgical techniqueitself and the post-operative period, when lifelong immunosuppression isrequired. In the early steps, careful retrieval and preservation of the pancreas arecrucial for the viability of the organ and ultimate success of the transplant. Thepancreas is a low-flow gland, making it highly sensitive to transplantationconditions and presenting risk of pancreatitis due to periods of ischemia. The twogroups of donors - after brain death (DBD) or after cardiac arrest (DCD) - requiredifferent strategies of retrieval and preservation to avoid or reduce the risk ofcomplications developing during and after the transplantation. For DBD donortransplantation, multiorgan retrieval and cold preservation is the conventionaltechnique. Asystole donor (DCD) transplantation, in contrast, can benefit from thenewest technologies, such as hypothermic and especially normothermicpreservation machines (referred to as NECMO), to optimize organ preservation.The latter has led to an increase in the pool of donors by facilitating recuperationof organs for transplantation that would have been discarded otherwise.