Enhancing Donated After Cardiac Death (DCD) Utilization With Thrombolytic Therapy

Enhancing DCD Utilization With Thrombolytic Therapy

We hypothesize that delayed graft function and ITBS events may be related to small blood clots (microthrombi) that collect in the kidneys and liver after cardiac death. Treatment of the DCD organs with a thrombolytic agent prior to implantation may reduce post-transplant morbidity and mortality, and may ultimately result in a greater number of transplantable livers and kidneys.

The waiting list for kidney and liver transplantation continues to increase in the United States, and therefore the need grows for additional donor organs. Utilization of organs donated after cardiac death (DCD) could be one way to increase organ availability, however there are risks associated with poorer clinical outcomes, including delayed graft function and in livers specifically, ischemic-type biliary strictures (ITBS). We hypothesize that delayed graft function and ITBS events may be related to small blood clots (microthrombi) that collect in the kidneys and liver after cardiac death. Treatment of the DCD organs with a thrombolytic agent prior to implantation may reduce post-transplant morbidity and mortality, and may ultimately result in a greater number of transplantable livers and kidneys.

Inclusion Criteria:

• Adults aged 18 years and older
• Subjects willing/able to provide written consent
• Subjects willing/able to comply with study requirements
• Subjects who will receive a solitary organ transplant

Exclusion Criteria:

• Subjects requiring multi-organ transplants
• Women who are pregnant
• Subjects with current severe systemic infection
• Subjects with an active infection