The role of extracorporeal membrane oxygenation in donation after circulatory death

C. Lazzeri, M. Bonizzoli, S. Valente, G. Cianchi, M. L. Migliaccio, G. F. Gensini, A. Peris

Research output: Contribution to journalArticlepeer-review


Donor scarcity and the increased need for organ transplantation has prompted the development of an alternative source of donors to the more conventional brain dead donor. While in a Beating-Heart donor, abdominal and intrathoracic organs are perfused, in a non-beating heart donor (NHBD, or DCD), perfusion should be maintained, after confirmation of death, by means of ECMO and inflation of intra-aortic balloon accordingly to the localization of the organs that should be transplanted. In this setting, ECMO allows selective perfusion of the organs which should be transplanted ("compartmental ECMO"). The present review is aimed at summarizing the rationale for ECMO use in organ donation in DCD and the available evidence on this topic, as well as available evidence (in clinical studies) on normothermic organ preservation using ECMO in adults. Despite the fact that available studies suffer from methodological limitations (small cohorts, retrospective analysis, not always comparative), they all reach the same conclusion: the concept of extracorporeal support with oxygenation in DCD seems very promising since it has been reported to increase the available organ supply by approximately 20% to 25%2 by increasing the number of donors by approximately 33%. Centres with ECMO facilities should implement local programmes for donation after cardiac death (both in the emergency department and intensive care) using ECMO taking into account that this technique has been proven to increase donor pool.

Original languageEnglish
Pages (from-to)1217-1227
Number of pages11
JournalMinerva Anestesiologica
Issue number11
Publication statusPublished - Nov 1 2014


  • Extracorporeal membrane oxygenation
  • Heart
  • Kidney
  • Liver
  • Lung
  • Tissue donors

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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