. 2020 Jan 27;20(8):2017–2025. doi: 10.1111/ajt.15775

Table 1.

Description of the techniques used for in situ perfusion of organs in DCD organ retrieval

In situ technique	Abbreviation	Description
Abdominal‐normothermic regional perfusion	A‐NRP	Oxygenated blood pumped by an extracorporeal circuit via a cannula in the abdominal aorta or common iliac artery and drained via a cannula in the inferior vena cava or common iliac vein. Alternatively, cannulation may be via the femoral vessels where allowed pre‐mortem The descending thoracic aorta and the inferior vena cava are occluded above the diaphragm to confine the circulation to the organs in the abdominal cavity
Direct (hypothermic) procurement and perfusion of the heart combined with abdominal‐normothermic regional perfusion	DPP with A‐NRP	Cannulae inserted into the abdominal aorta and inferior vena cava or the common iliac vessels for extracorporeal circulation. The descending thoracic aorta is occluded before starting circulation to the abdominal organs. The ascending aorta is clamped distal to a cannula inserted proximally to allow the administration of cold preservation solution and excision of the heart without restarting it in situ
Thoraco abdominal‐normothermic regional perfusion	TA‐NRP	The extracorporeal circulation is provided by cannulae in the abdominal aorta or common iliac artery and in the right atrium or inferior vena cava. The descending thoracic aorta is not occluded to allow delivery of oxygenated blood to both the thoracic and abdominal organs

In situ technique

Abbreviation

Description

Abdominal‐normothermic regional perfusion

A‐NRP

Oxygenated blood pumped by an extracorporeal circuit via a cannula in the abdominal aorta or common iliac artery and drained via a cannula in the inferior vena cava or common iliac vein. Alternatively, cannulation may be via the femoral vessels where allowed pre‐mortem

The descending thoracic aorta and the inferior vena cava are occluded above the diaphragm to confine the circulation to the organs in the abdominal cavity

Direct (hypothermic) procurement and perfusion of the heart combined with abdominal‐normothermic regional perfusion

DPP with A‐NRP

Cannulae inserted into the abdominal aorta and inferior vena cava or the common iliac vessels for extracorporeal circulation. The descending thoracic aorta is occluded before starting circulation to the abdominal organs. The ascending aorta is clamped distal to a cannula inserted proximally to allow the administration of cold preservation solution and excision of the heart without restarting it in situ

Thoraco abdominal‐normothermic regional perfusion

TA‐NRP

The extracorporeal circulation is provided by cannulae in the abdominal aorta or common iliac artery and in the right atrium or inferior vena cava. The descending thoracic aorta is not occluded to allow delivery of oxygenated blood to both the thoracic and abdominal organs

Abbreviations: DCD, donation after circulatory death; A‐NRP, abdominal‐normothermic regional perfusion; TA‐NRP, thoraco‐abdominal‐ normothermic regional perfusion; DPP, direct (hypothermic) procurement and perfusion; NRP, normothermic regional perfusion.