{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:20:36Z","timestamp":1784737236264,"version":"3.55.0"},"reference-count":5,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl Int"],"abstract":"<jats:p>Thoraco-abdominal normothermic regional perfusion (TA-NRP), utilizing Extra Corporeal Membrane Oxygenation (ECMO) devices, has emerged as an effective strategy for heart recovery in donors declared dead by circulatory criteria (DCDD). After death declaration, TA-NRP restores heart activity by reperfusing the arrested heart with oxygenated blood at normothermia. Mechanical ventilation resumption in the donor enables weaning from ECMO and restores systemic circulation and oxygenation using the donor\u2019s heart and lungs. However, if pre-existing conditions prevent the donor\u2019s lungs from oxygenating blood post-cardiac activity restoration, weaning from veno-arterial ECMO may lead to systemic hypoxia, jeopardizing the restored cardiac function. Anticipating this scenario may guide planning a split ECMO circuit to facilitate earlier and more effective recovery of donor heart function post-ECMO weaning. This manuscript describes three cases of DCDD donors with hypoxic respiratory failure undergoing TA-NRP for heart recovery. By establishing a bridge in the arterial portion of the circuit, clamped out after weaning from veno-arterial ECMO, donor heart function was assessed exclusively with veno-venous ECMO support, leading to successful heart transplantation.<\/jats:p>","DOI":"10.3389\/ti.2024.13526","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T04:11:23Z","timestamp":1731989483000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Overcoming Lung Challenges in TA-NRP Assisted Heart Recovery in Donation After the Circulatory Determination of Death"],"prefix":"10.3389","volume":"37","author":[{"given":"Mario","family":"Royo-Villanova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Moya S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Ort\u00edn Freire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose H.","family":"De Gea Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Rebollo Acebes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Moreno Flores","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Blanco Morillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"C\u00e1novas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Dom\u00ednguez-Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"101887","DOI":"10.1016\/j.eclinm.2023.101887","article-title":"The International Experience of In-Situ Recovery of the DCD Heart: A Multicentre Retrospective Observational Study","volume":"58","author":"Louca","year":"2023","journal-title":"EClinicalMedicine"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1016\/j.healun.2016.07.004","article-title":"Functional Assessment and Transplantation of the Donor Heart after Circulatory Death","volume":"35","author":"Messer","year":"2016","journal-title":"J Heart Lung Transpl"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1016\/j.healun.2017.10.021","article-title":"Outcome after Heart Transplan-Tation from Donation after Circulatory-Determined Death Donors","volume":"36","author":"Messer","year":"2017","journal-title":"J Heart Lung Transpl"},{"key":"B4","volume-title":"Protocolo Nacional de Trasplante Cardiaco de Donante en Asistolia Controlada","year":"2023"},{"key":"B5","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.ajt.2023.09.008","article-title":"Maintaining the Permanence Principle of Death during Normothermic Regional Perfusion in Controlled Donation after the Circulatory Determination of Death: Results of a Prospective Clinical Study","volume":"24","author":"Royo-Villanova","year":"2023","journal-title":"Am J Transpl"}],"container-title":["Transplant International"],"original-title":[],"link":[{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/ti.2024.13526\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T04:11:25Z","timestamp":1731989485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontierspartnerships.org\/articles\/10.3389\/ti.2024.13526\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":5,"alternative-id":["10.3389\/ti.2024.13526"],"URL":"https:\/\/doi.org\/10.3389\/ti.2024.13526","relation":{},"ISSN":["1432-2277"],"issn-type":[{"value":"1432-2277","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,19]]},"article-number":"13526"}}