CASE REPORT article
Front. Transplant.
Sec. Abdominal Transplantation
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1680491
Organ procurement in a DCD donor with ovarian thecoma: abdominal NRP enabled timely and safe resection, pathological confirmation, and successful kidney transplantation.
Provisionally accepted
Benjamin Assouline1Timothée Olivier2
Anne-Laure Rougemont Md3Philippe Compagnon4
Charles-Henri Wassmer4Hervé Quintard1
Karim Bendjelid1Franz Immer5
Raphael GIRAUD1*- 1Intensive Care Division, Department of Acute Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- 2Division of Oncology, Geneva University Hospitals, Geneva, Switzerland
- 3Division of Clinical Pathology, Geneva University Hospitals, Geneva, Switzerland
- 4Division of transplantation, Geneva University Hospitals, Geneva, Switzerland
- 5Universitat Bern, Bern, Switzerland
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Donation after circulatory death (DCD) may be complicated by incidental findings, including tumor lesions that require urgent diagnosis. We describe the case of a DCD donor with a large adnexal mass in whom abdominal normothermic regional perfusion (A-NRP) enabled safe resection, real-time pathological analysis, and subsequent kidney transplantation. Case summary: A 60-year-old woman suffered a hypoxic cardiac arrest and subsequently remained in deep coma with poor neurological prognostic indicators. In accordance with her presumed wishes, withdrawal of life support was performed, and a controlled DCD procedure with abdominal normothermic regional perfusion (A-NRP) was initiated. Imaging revealed a 27-cm adnexal mass. Laboratory markers showed elevated CA-125 but low CA 19-9 and CEA, and cytology was negative. Bilateral oophorectomy was performed under A-NRP, and frozen section excluded malignancy, with final pathology confirming an ovarian thecoma. Both kidneys were procured; only the left was transplanted successfully. The recipient had immediate diuresis and stable renal function at 1 month. Discussion: This case illustrates how A-NRP provides oxygenated perfusion while allowing time for surgical excision and pathological diagnosis of incidental tumors. It prevented unnecessary donor exclusion and enabled transplantation. Conclusion: In selected DCD donors with incidental lesions, A-NRP can safely bridge the diagnostic process, preserve organ viability, and expand the donor pool.
Keywords: normothermic regional perfusion, Pathological diagnosis, organ procurement, Organ Transplantation, ovarian serous cystadenofibroma, Thecoma
Received: 06 Aug 2025; Accepted: 09 Sep 2025.
Copyright: © 2025 Assouline, Olivier, Rougemont Md, Compagnon, Wassmer, Quintard, Bendjelid, Immer and GIRAUD. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Raphael GIRAUD, raphael.giraud@hug.ch
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.