{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:33:38Z","timestamp":1777916018444,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart transplantation team of the Heart Institute of the Ministry of Health of Ukraine performs thoracoabdominal normothermic regional perfusion (TA-NRP) procedure for organ preconditioning in marginal donors. Martial law in Ukraine worsens preexisting shortage of donor organs since February 2022. The use of TA-NRP has been shown to be effective in rescucitating organs in donors with circulatory determination of death (CDD), and we hypothesize that TA-NRP can be used to perform in situ organ perfusion in donors with neurological determination of death (NDD) as well, thereby improve organ quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single centre, retrospective analysis of outcomes after heart transplantation using organs from donors with NDD who underwent TA-NRP for preconditioning from 2022 to 2024 year at the Heart Institute Ministry of Health of Ukraine. The indications for TA-NRP were hemodynamic instability of donors with NDD, characterized by the need for norepinephrine &gt;1.0\u00a0\u03bcg\/kg\/h to maintain mean blood pressure &gt;50\u00a0mm Hg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TA-NRP for donor preconditioning was performed in 12 cases (11.3%) of 106 heart transplantations between 2019 and 2023. The average duration of TA-NRP was 124.5 \u00b1 10.1\u00a0minutes. Prior to TA-NRP initiation, all donors exhibited metabolic acidosis, hyperkalemia, and hyperlactatemia. The implementation of TA-NRP normalized the acid-base balance, demonstrated by a significant increase in pH (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001), correction of base excess (BE) (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001), and an increase in bicarbonate levels (HCO3-) (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001). TA-NRP also significantly reduced baseline lactate levels from 10.4 \u00b1 2.91\u00a0mmol\/L to 1.57 \u00b1 0.33\u00a0mmol\/L (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .001) and decreased potassium levels (\n                      <jats:italic>p<\/jats:italic>\n                      = .003). Additionally, it led to a significant reduction in donor heart rate (\n                      <jats:italic>p<\/jats:italic>\n                      = .001) and an increase in mean arterial pressure (\n                      <jats:italic>p<\/jats:italic>\n                      = .012), accompanied by a 6.6-fold reduction in donor norepinephrine requirements (\n                      <jats:italic>p<\/jats:italic>\n                      = .003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The use of TA-NRP in donors with NDD improved organ quality which resulted in 30 days survival rate of 83% and 1-year survival rate of 75% in organ recipients.<\/jats:p>\n                  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Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Melnyk","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, PL Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Kuzmych","sequence":"additional","affiliation":[{"name":"Department of Intensive Care for Adults, Heart Institute Ministry of Health of Ukraine, Kyiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-092X","authenticated-orcid":false,"given":"J.","family":"Swol","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Paracelsus Medical University, Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali S.","family":"Merza","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular 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