Optimizing the timing of organ procurement from donors after brainstem death: Impact on outcomes in abdominal organ transplantation - A systematic review.
Koliakos N., et al.Transplant Rev (Orlando). 2026 Jan;40(1):100987.
Aims
This aim of this study was to compile and summarise the available evidence on how procurement timing affects kidney, liver and pancreas transplant outcomes.
Interventions
Four databases were searched for literature: Embase, Medline, Scopus and Web of Knowledge. The search and inclusion of studies were performed by two independent reviewers.
Participants
6 studies were included in the review.
Outcomes
The main outcomes of interest were patient survival, graft survival and the incidence of delayed graft function.
Follow-up
N/A
CET Conclusions
This report describes an interesting and well-conducted systematic review. The key concept is to investigate the impact of the “procurement interval”, the time from declaration of brain death to organ retrieval. Only 6 studies met the inclusion criteria, however together they encompass over 190,000 donors. Due to the heterogeneity of the studies, and the varying impact on different organs and outcomes, a narrative analysis is provided and no meta-analysis done. Across liver, pancreas and kidney transplantation longer procurement intervals were associated with better outcomes such as graft survival, early function and rejection. These outcomes were not consistent across all organs and the causation is not fully understood. It is reasonable that a sufficient period to mitigate the downstream impact of brain death on abdominal organs could have a positive impact on transplant outcomes. There is some evidence that the impact on donor lungs is the opposite however, with the negative consequences of prolonged ventilation coming into play, and the impact on hearts is unclear.
Trial registration
PROSPERO - CRD420251126283