Thoraco-abdominal normothermic regional perfusion does not restore cerebral blood flow or electrical activity despite collateral supra-aortic blood flow in a porcine model

Thoraco-abdominal normothermic regional perfusion does not restore cerebral blood flow or electrical activity despite collateral supra-aortic blood flow in a porcine model

Background: It is unknown whether ligation of supra-aortic vessels during thoraco-abdominal normothermic regional perfusion (TA-NRP) can prevent postmortem brain function, ensuring the permanence of death. Our objective was to determine if ligation of the supra-aortic vessels during TA-NRP prevents...

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Main Authors: Matthieu Glorion, MD MSc, Joel Neves Briard, MD MSc, Louise Roquebert, Sabina Pizzi, Ahmed Menaouar, PhD, Mélanie Borie, MSc, Manon Robert, MSc, Dang Khoa Nguyen, MD PhD, Michaël Chassé, MD PhD, Basil Nasir, MD, Pasquale Ferraro, MD, Shant Der Sarkissian, PhD, MBA, Pierre-Emmanuel Noly, MD PhD, Nicolas Noiseux, MD PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:JHLT Open
Subjects:
organ donation
cardiocirculatory death
animal model
electroencephalography
angiography
thoraco-abdominal normothermic regional perfusion (TA-NRP)
Online Access:http://www.sciencedirect.com/science/article/pii/S2950133425000163
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Summary:Background: It is unknown whether ligation of supra-aortic vessels during thoraco-abdominal normothermic regional perfusion (TA-NRP) can prevent postmortem brain function, ensuring the permanence of death. Our objective was to determine if ligation of the supra-aortic vessels during TA-NRP prevents resumption of intracranial blood flow, brain electrical activity and clinical brain function in a porcine model of organ donation after circulatory arrest. Methods: Neuromonitoring was performed in 9 porcine experiments, in which supra-aortic vessels were ligated. Results: During TA-NRP and organ procurement, no motor reaction to pain, spontaneous ventilation, eye movement or change in pupillary function were observed. Angiography demonstrated absence of supra-aortic blood flow in 4 (44%) experiments and delayed, discrete and transient supra-aortic extracranial opacification in 5 (56%) experiments. No intracranial blood flow was observed. All electroencephalograms demonstrated absent brain electrical activity. Conclusion: In this porcine model, occlusion of the supra-aortic vessels during TA-NRP did not restore post-mortem cerebral blood flow or electrical activity and is in adequation with the permanence of death.
ISSN:2950-1334

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