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Am J Transplant ; 22(7): 1852-1860, 2022 07.
Article in English | MEDLINE | ID: covidwho-1937907


Despite the benefits of abdominal normothermic regional perfusion (A-NRP) for abdominal grafts in controlled donation after circulatory death (cDCD), there is limited information on the effect of A-NRP on the quality of the cDCD lungs. We aimed to study the effect of A-NRP in lungs obtained from cDCD and its impact on recipients´ outcomes. This is a study comparing outcomes of lung transplants (LT) from cDCD donors (September 2014 to December 2021) obtained using A-NRP as the abdominal preservation method. As controls, all lung recipients transplanted from donors after brain death (DBD) were considered. The primary outcomes were lung recipient 3-month, 1-year, and 5-year survival. A total of 269 LT were performed (60 cDCD and 209 DBD). There was no difference in survival at 3 months (98.3% cDCD vs. 93.7% DBD), 1 year (90.9% vs. 87.2%), and 5 years (68.7% vs. 69%). LT from the cDCD group had a higher rate of primary graft dysfunction grade 3 at 72 h (10% vs. 3.4%; p <  .001). This is the largest experience ever reported with the use of A-NRP combined with lung retrieval in cDCD donors. This combined method is safe for lung grafts presenting short-term survival outcomes equivalent to those transplanted through DBD.

Liver Transplantation , Lung Transplantation , Tissue and Organ Procurement , Brain Death , Death , Graft Survival , Humans , Liver Transplantation/methods , Organ Preservation/methods , Perfusion/methods , Retrospective Studies , Tissue Donors
Transplant Proc ; 52(9): 2707-2710, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-899628


The coronavirus disease 2019 (COVID-19) pandemic has changed life on a global scale. The numbers of transplantations have plummeted as a result of fear of disease transmission, recipient coronavirus disease 2019 infection, priority shift, and resource limitations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) complicates transplantation because donor testing, (re)allocation of limited resources, and recipient testing may exceed permissible ischemia times. Normothermic machine perfusion (NMP) helps safely prolong liver preservation up to 38 hours. Additional time is essential under the current circumstances. Here we present the case of a 29-year-old liver transplant recipient in whom prolonged liver preservation required for SARS-CoV-2 screening was accomplished through NMP. Donor and recipient test results for SARS-CoV-2 were negative, and intensive care unit capacity was eventually available. The surgical procedure and postoperative course were uneventful. NMP can extend preservation times in liver transplantation while awaiting SARS-CoV-2 test results and available intensive care unit capacity.

Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Liver Transplantation/methods , Organ Preservation/methods , Pneumonia, Viral/diagnosis , Adult , Betacoronavirus , COVID-19 , COVID-19 Testing , Female , Humans , Pandemics , Perfusion/methods , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Tissue Donors
Transfusion ; 60(9): 1905-1909, 2020 09.
Article in English | MEDLINE | ID: covidwho-613577


New York is at the epicenter of the coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus. Columbia University Irving Medical Center/NewYork-Presbyterian Hospital (CUIMC/NYPH) had to make changes to its cellular therapy operations to ensure patient, donor, and staff safety and well-being. In this article, we discuss the process changes we instituted for cellular therapy clinical care, collection, processing, and cryopreservation to cope with the rapidly evolving pandemic.

Academic Medical Centers , COVID-19/epidemiology , Cell- and Tissue-Based Therapy/statistics & numerical data , Pandemics , SARS-CoV-2 , Academic Medical Centers/organization & administration , Academic Medical Centers/statistics & numerical data , Adult , Bone Marrow Transplantation/methods , Bone Marrow Transplantation/statistics & numerical data , COVID-19 Testing , Cell Separation/methods , Child , Clinical Trials as Topic/organization & administration , Cryopreservation/methods , Donor Selection , Humans , Immunotherapy, Adoptive/methods , Immunotherapy, Adoptive/statistics & numerical data , Lymphocyte Transfusion/methods , Lymphocyte Transfusion/statistics & numerical data , New York City/epidemiology , Organ Preservation/methods , Peripheral Blood Stem Cell Transplantation/methods , Peripheral Blood Stem Cell Transplantation/statistics & numerical data , Preservation, Biological/methods , Procedures and Techniques Utilization , Tissue Donors , Tissue and Organ Procurement/methods , Tissue and Organ Procurement/organization & administration