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Most of the organs can only be kept viable within very limited timeframes (e.g., mere 4\u20136\u00a0h for heart and lungs exposed to refrigeration temperatures ex vivo). Donation after circulatory death (DCD) using extracorporeal membrane oxygenation (ECMO) can significantly enlarge the donor pool, organ yield per donor, and shelf life. Nevertheless, clinical attempts to recover organs for transplantation after uncontrolled DCD are extremely complex and hardly reproducible. Therefore, as a preliminary strategy to fulfill this task, experimental protocols using feasible animal models are highly warranted. The primary aim of the study was to develop a model of ECMO-based cadaver organ recovery in mice. Our model mimics uncontrolled organ donation after an \u201cout-of-hospital\u201d sudden unexpected death with subsequent \u201cin-hospital\u201d cadaver management post-mortem. The secondary aim was to assess blood gas parameters, cardiac activity as well as overall organ state. The study protocol included post-mortem heparin\u2013streptokinase administration 10\u00a0min after confirmed death induced by cervical dislocation under full anesthesia. After cannulation, veno-arterial ECMO (V\u2013A ECMO) was started 1\u00a0h after death and continued for 2\u00a0h under mild hypothermic conditions followed by organ harvest. Pressure- and flow-controlled oxygenated blood-based reperfusion of a cadaver body was accompanied by blood gas analysis (BGA), electrocardiography, and histological evaluation of ischemia\u2013reperfusion injury. For the first time, we designed and implemented, a not yet reported, miniaturized murine hemodialysis circuit for the treatment of severe hyperkalemia and metabolic acidosis post-mortem.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>BGA parameters confirmed profound ischemia typical for cadavers and incompatible with normal physiology, including extremely low blood pH, profound negative base excess, and enormously high levels of lactate. Two hours after ECMO implantation, blood pH values of a cadaver body restored from\u2009&lt;\u20096.5 to 7.3\u2009\u00b1\u20090.05, pCO<jats:sub>2<\/jats:sub> was lowered from\u2009&gt;\u2009130 to 41.7\u2009\u00b1\u200910.5\u00a0mmHg, sO<jats:sub>2<\/jats:sub>, base excess, and HCO<jats:sub>3<\/jats:sub> were all elevated from below detection thresholds to 99.5\u2009\u00b1\u20090.6%, \u2212\u00a04\u2009\u00b1\u20096.2 and 22.0\u2009\u00b1\u20096.0\u00a0mmol\/L, respectively (Student <jats:italic>T<\/jats:italic> test, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). A substantial decrease in hyperlactatemia (from\u2009&gt;\u200920 to 10.5\u2009\u00b1\u20091.7\u00a0mmol\/L) and hyperkalemia (from\u2009&gt;\u20099 to 6.9\u2009\u00b1\u20091.0\u00a0mmol\/L) was observed when hemodialysis was implemented. On balance, the first signs of regained heart activity appeared on average 10\u00a0min after ECMO initiation without cardioplegia or any inotropic and vasopressor support. This was followed by restoration of myocardial contractility with a heart rate of up to 200 beats per minute (bpm) as detected by an electrocardiogram (ECG). Histological examinations revealed no evidence of heart injury 3\u00a0h post-mortem, whereas shock-specific morphological changes relevant to acute death and consequent cardiac\/circulatory arrest were observed in the lungs, liver, and kidney of both control and ECMO-treated cadaver mice.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Thus, our model represents a promising approach to facilitate studying perspectives of cadaveric multiorgan recovery for transplantation. Moreover, it opens new possibilities for cadaver organ treatment to extend and potentiate donation and, hence, contribute to solving the organ shortage dilemma.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40635-023-00534-2","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T23:03:09Z","timestamp":1691103789000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multiorgan recovery in a cadaver body using mild hypothermic ECMO treatment in a murine model"],"prefix":"10.1186","volume":"11","author":[{"given":"Nodir","family":"Madrahimov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitalii","family":"Mutsenko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruslan","family":"Natanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dejan","family":"Radakovi\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Klapproth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"Rosenfeldt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Kleefeldt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Aleksic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00fcleyman","family":"Erg\u00fcn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Otto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer G.","family":"Leyh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanze","family":"Bening","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"534_CR1","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1097\/01.TP.0000437178.48174.db","volume":"97","author":"PE Morrissey","year":"2014","unstructured":"Morrissey PE, Monaco AP (2014) Donation after circulatory death: current practices, ongoing challenges, and potential improvements. 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