Addition of direct peritoneal lavage to human cadaver organ donor resuscitation improves organ procurement

Journal of the American College of Surgeons
Jason W SmithR Neal Garrison

Abstract

Brain dead organ donors have altered central hemodynamic performance, impaired hormone physiology, exaggerated systemic inflammatory response, end-organ microcirculatory dysfunction, and tissue hypoxia. A new treatment, direct peritoneal resuscitation (DPR), stabilizes vital organ blood flow after conventionally resuscitated shock to improve these derangements. A prospective case-control study of adjunctive DPR compared 26 experimental patients (brain dead organ donors) to 52 controls (protocolized conventionally resuscitated donors). Actual organ procurement rates were compared with the Scientific Registry of Transplant Recipient predicted organ yield per patient. Achievement of donor management goals and effective hepatic blood flow were recorded. Fourteen of 26 (53.8%) patients treated with DPR achieved all donor management goals compared with 17 of 52 (32.7%) patients treated with conventionally resuscitated (odds ratio = 2.4; 95% CI, 0.92-6.3; p = 0.06). Patients treated with DPR were more than 2 times as likely to achieve final pO2 >100 on 40% FiO2 compared with controls (odds ratio = 2.8; 95% CI, 1-7.69; p = 0.03). Also, DPR-treated patients required less IV crystalloid during the first 12 hours of management (DPR: 3,167...Continue Reading

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Citations

Jun 28, 2016·Journal of the American College of Surgeons·Jessica L WeaverJason W Smith
Sep 20, 2015·International Journal of Surgery·Jessica L Weaver, Jason W Smith
Feb 8, 2018·Oxidative Medicine and Cellular Longevity·Anne C Van ErpJean-Paul Decuypere
Mar 26, 2019·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Jessica L WeaverJason W Smith
Dec 2, 2017·The Journal of Trauma and Acute Care Surgery·Jessica L WeaverJason W Smith
Jun 18, 2016·Current Opinion in Critical Care·Jayshil J PatelRobert G Martindale
Apr 19, 2018·American Journal of Physiology. Renal Physiology·Jessica L WeaverJason W Smith
Jan 22, 2020·Critical Care Nurse·Steven WisemanKatie Love Bower
Nov 15, 2017·The Surgical Clinics of North America·Mack DrakeEugene Hessel
Nov 14, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Marcelo Augusto Fontenelle Ribeiro-JuniorSalomone Di Saverio

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