The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2026
Neuromonitoring during heart retrieval using thoracoabdominal normothermic regional perfusion: A prospective cohort study.
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Tur Ana, Lo Elaine, Martín-González Iván, Zarragoikoetxea Iratxe, Carmona Paula, López-Cantero Marta, Pérez-Montejano Rut, Tebar Eduardo, Gimeno Ricardo, Talavera Mónica, Palau Cristian, Villarreal Esther, Monfort Verónica, Martínez-León Juan, Carbonell José, Segura José Manuel, Almenar Luís, Romero-García Nekane, Badenes Rafael, Lazaridis Christos
Аннотация
We conducted a prospective consecutive-patient neuromonitoring trial to assess brain function and flow during heart retrieval using thoracoabdominal normothermic regional perfusion (TA-NRP). Bispectral Index (BIS), quantitative pupillometry, and transcranial Doppler (TCD) were employed at multiple timepoints including: 1) before withdrawal of life-sustaining treatments (WLST) and 2) after exclusion of the circulation to the brain and TA-NRP initiation at 3-time intervals: 1, 5, and 10 min. A total of 43 TANRP heart donors were included in this study. Post-NRP initiation, neurological pupil index (NPI) was 0 for both pupils for all donors. TCD showed flow in at least one vessel for all donors prior to WLST and no flow in any vessel for all donors post-NRP. Median BIS was 31 (24, 37) before WLST and reached 0 for all donors post-NRP. Larger-scale multicenter studies are needed to definitively confirm these findings. Such validation is essential for providing necessary reassurance that TA-NRP does not restore brain blood flow nor brain functions.