EXTRACORPOREAL PERFUSION FOR OBTAINING POSTMORTEM HOMOGRAFTS.

Abstract

Functional renal homografts have been obtained as long as 14 hours post mortem by a technique of extracorporeal cadaver perfusion. The method has also given satisfactory liver homografts after perfusion up to 2 hours. Details of the technique and experimental and clinical applications are described. Analysis of the data indicates that optimal perfusion times for renal homografts should not exceed 6 hours. For the liver, 2 hours appears to be the maximum tolerable period of perfusion. For clinical application, certain adjuvant measures are important. Perfusion failure has been encountered in human cadavers, presumably as a result of the presence of a reduced blood volume. This can be prevented by acute postmortem expansion of the intravascular volume with compatible whole blood or plasma. Proper donor selection is as important a factor as the method used for preservation. Indirect evidence is cited that premortem tissue injury in protracted terminal disease may be a greater deterent to success than the parenchymal damage which occurs during postmortem perfusion. The extension of this technique for the procurement of other organs such as heart and lung is discussed.