Normothermic regional perfusion performed by a United States organ procurement organization for nonthoracic organ donors
Marty T. Sellers, Jill Grandas, Matthew Warhoover, John S. Poland, Deana C. Clapper
Abstract
Normothermic regional perfusion (NRP) has the potential to increase the number and quality of transplanted organs. Most reports showing the advantages of NRP have been from transplant centers, but not all centers perform NRP. These advantages could be broadened if organ procurement organizations (OPOs) also performed NRP. We report donation and transplantation outcomes of our first 90 OPO-based NRP nonthoracic donors, divided into 3 eras (n = 30 each). Comparisons were made with donation after circulatory determination of death direct procurement (DP; n = 270) and donation after brain death (DBD; n = 729) donors. NRP donor median age was 53 years, compared to DP (48 years, P = .004) and DBD (44 years, P < .001) donors. NRP liver utilization (69%, 18 accepting centers) was superior to DP (17%, P < .001) and not significantly different from DBD utilization (79%, P = .27) in multivariate analysis. By era, NRP liver utilization progressively increased: 53%, 70%, 83% (P = .04). NRP kidney use rate (71%) was higher than in DP (60%, P = .02) and not significantly different from DBD (76%, P = .15), especially among older donors. NRP kidney delayed graft function incidence (29%) was lower than in DP (47%, P = .001) and not significantly different from DBD (32%, P = .53) donors. OPO-based NRP can provide more livers and kidneys to multiple transplant centers and improve outcomes from nonthoracic organ donors.