307.2: Successful liver and kidney transplantations from a donor with left ventricular assist device.

Abstract

Background: Organ transplantation from donors with ventricular assist devices are not common. Here, we report organ retrieval from a donor with a left ventricular assist device (LVAD) who was on the heart transplant waiting list before brain death diagnosis. Presentation of Case: The organ donor was diagnosed with dilated cardiomyopathy and underwent LVAD surgery for bridging to heart transplantation in 2016. Brain death occurred 22 months after LVAD implantation at the age of 39 due to widespread intraparenchymal and subarachnoid hemorrhage. Brain death diagnosis was confirmed with brain perfusion SPECT (Tc-99m HMPAO). In accordance with the donor’s will, the relatives approved organ donation. The donor’s organ reserve was assessed to be suitable for liver and kidney transplants and proper donor care was given. During organ harvesting, cardiovascular surgeons accompanied the organ transplant team to control LVAD flow and ensure optimum organ perfusion. After a successful operation, the liver was transplanted to a patient awaiting liver transplantation for 13 years with a diagnosis of primary sclerosing cholangitis, the kidneys were transplanted to patients awaiting kidney transplantation for 31 and 14 years with diagnoses of nephrolithiasis and polycystic kidney disease, respectively. No complications occurred among the liver and kidney transplant recipients. Conclusions: There are very few reported donors with assist device. This is the first case of an organ donor with an assist device waiting for an organ transplantation who became an actual donor in our country.