Preclinical Modeling of DCD Class III Donation: Paving the Way for the Increased Use of This Challenging Donor Type

Autor: David Soussi, Xavier Rod, Raphael Thuillier, Suzanne Leblanc, Jean-Michel Goujon, Benoit Barrou, Thierry Hauet, Thomas Kerforne
Přispěvatelé: Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital pasteur [Colmar], University Hospital Federation Suport, Partenaires INRAE, IBiSA Plateforme, Plate-forme MOdélisation Préclinique - Innovation Chirurgicale et Technologique (MOPICT), Institut National de la Recherche Agronomique (INRA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pinet, Nicolas
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: BioMed Research International
BioMed Research International, Hindawi Publishing Corporation, 2019, 2019, pp.1-9. ⟨10.1155/2019/5924101⟩
BioMed Research International, Vol 2019 (2019)
ISSN: 2314-6133
2314-6141
DOI: 10.1155/2019/5924101⟩
Popis: International audience; Deceased after circulatory death (DCD) donors offer a viable solution to the current organ shortage, particularly the Maastricht Class III (arrest subsequent to cessation of life support in the hospital). Although current results from these donors are very satisfactory, the number of included donors is too low and future expansion of inclusion criteria will likely decrease organ quality, with negative consequences on the complication rate. This donor type thus represents a priority in terms of scientific exploration, so as to study it in controlled settings and prepare for future challenges. Hence, we mimicked the DCD Class III clinical conditions a Large White pig model. Herein, we detail the different strategies attempted to attain our objectives, including technical approaches such as animal positioning and ventilator settings, as well as pharmacological intervention to modulate blood pressure and heart rate. We highlight the best combination of factors to successfully reproduce DCD Class III conditions, with perfusion pressures and functional warm ischemia (hypoperfusion) closely resembling clinical situations. Finally, we detail the functional and histological impacts of these conditions. Such a model could be of critical value to explore novel management alternative for these donors, presenting a uniquely adapted platform for such therapeutics as normothermic regional circulation and/or pharmacological intervention.
Databáze: OpenAIRE
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