2013 - ISBTS 2013 Symposium

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Posters and Exhibition

15.61 - Multicenter study to asses short and long term outcomes of every graft harvested as part of multiorgan procurement that included intestine

Presenter: Luis, Moulin, , Argentina
Authors: Pablo Farinelli1, Juan Manuel Padin1, Luis Moulin1, Juan Troncoso5, Alejandro Bertolotti2, Marcelo Lenz6, Nicolas Sanchez8, Rita Fortunato4, Esteban Caravello6, Nora Imperiali6, Marcelo Dip7, Mariano Arriola9, Jorge De Arteaga10, Gervasio Pujol Soler11, Octavio Gil12, Lucas Mc Cormack13, Edgardo Botta9, Oscar Inventarza14, Luis Gaite6, Sun H Hyon6, Pablo Raffaele4, Gabriel Illanes8, Eduardo De Santibañez6, Roberto Favaloro3, Liliana Bisigniano5, Gabriel Eduardo Gondolesi1

Multicenter study to asses short and long term outcomes of every graft harvested as part of multiorgan procurement that included intestine

Pablo Farinelli1, Juan Manuel Padin1, Luis Moulin1, Juan Troncoso5, Alejandro Bertolotti2, Marcelo Lenz6, Nicolas Sanchez8, Rita Fortunato4, Esteban Caravello6, Nora Imperiali6, Marcelo Dip7, Mariano Arriola9, Jorge De Arteaga10, Gervasio Pujol Soler11, Octavio Gil12, Lucas Mc Cormack13, Edgardo Botta9, Oscar Inventarza14, Luis Gaite6, Sun H Hyon6, Pablo Raffaele4, Gabriel Illanes8, Eduardo De Santibañez6, Roberto Favaloro3, Liliana Bisigniano5, Gabriel Eduardo Gondolesi1

1Multiorgan Transplant Institute, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 2Toracic Surgery, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 3Cardiovascular Surgery and Transplant, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 4Nephrology and Urology, Favaloro's Foundation University Hospital, Ciudad Autonoma de Buenos Aires, Argentina; 5Instituto Nacional Central Único Coordinador de Ablación e Implante, INCUCAI, Ciudad Autonoma de Buenos Aires, Argentina; 6Hospital Italiano de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina; 7Hospital de Pediatría SAMIC Prof. Dr. Juan Pedro Garrahan, Ciudad Autonoma de Buenos Aires, Argentina; 8Instituto de Nefrología Nephrology S.A, Ciudad Autonoma de Buenos Aires, Argentina; 9Clínica de Nefrología, Urología y Enfermedades Cardiovasculares de la Ciudad de Santa Fe SA, Santa Fe, Argentina; 10Hospital Privado de Cordoba, Cordoba, Argentina; 11Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno” (CEMIC), Vicente Lopez, Argentina; 12Hospital Allende, Cordoba, Argentina; 13Hospital Aleman, Ciudad Autonoma de Buenos Aires, Argentina; 1411Hospital General de Agudos “Dr. Cosme Argerich”, Ciudad Autonoma de Buenos Aires, Argentina

Introduction: Development of intestinal transplant (Tx) programs introduces thymoglobulin donor treatment, as well as complex surgical technique with almost complete warm dissection in order to ensure availability of all abdominal organs for transplantation.
 
Aim:  To report short and long term outcomes of every graft harvested as part of multiorgan procurement (MTOp) including the intestine.
 
Material and Methods: Data was collected of all organs harvested from MTOp including the intestines allocated to our center from March 2006 to July 2011.
 
Results:127/129 organs, procured from 29 MTOp were transplanted in 101 patients. This activity involved 29 transplant programs based in 18 hospitals nationwide. 24/29 programs (83%) answered the survey. Data from 92 recipients and 116 organs were included in the analysis. Five intra-thoracic Tx programs used 12 hearts, 2 lungs and 1 cardio-pulmonary block in 15 recipients; 4/12 hearts (33.3%) and the block developed primary graft dysfunction (PGD). The survival was 75% and 100% for hearts and lungs, respectively. Nineteen abdominal Tx programs used 19 livers, 9 kidney-pancreas (KP), 19 kidneys and 29 intestines. None of the liver grafts developed PGD; 3/9 KP required insulin for an average of 5 days, and other 3 exhibited DGF of the K; 4/19 Tx kidneys (21%) had DGF. The survival was 84%, 78%, 95% and 65,5% for livers, kidney-pancreas, kidneys and intestines, respectively.
 
Conclusions:Surgical technique of MTOp allow safe use of every organ harvested in the procedure. In spite of needing longer time and team efforts, short and long term graft and patient survivals are better of those obtained in regular procurements without the intestines and reported by national and international series.

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