Implementing Thoracoabdominal Normothermic Regional Perfusion (TA-NRP) in multi-organ Donation after Circulatory Death (DCD) represents a paradigm shift that redefines lung procurement by restoring an in situ functional circulatory state. Following the declaration of death and surgical entry, the brachiocephalic arteries are definitively ligated to prevent any cerebral reperfusion, and an extracorporeal membrane oxygenation (ECMO) circuit is established via cannulation of the right atrium and ascendingaorta. By re-establishing warm, oxygenated blood flow to both the thoracic and abdominal compartments simultaneously, TA-NRP successfully mitigates the devastating effects of the warm ischemic interval on the pulmonary vascular bed and parenchyma.
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