Literature DB >> 33248525

A 5-year single-center early experience of heart transplantation from donation after circulatory-determined death donors.

Simon Messer1, Sendi Cernic1, Aravinda Page1, Marius Berman1, Pradeep Kaul1, Simon Colah1, Jason Ali1, Evgeny Pavlushkov1, Jen Baxter1, Richard Quigley1, Mohamed Osman1, Eyal Nachum1, Jayan Parameshwar1, Yasir Abu-Omar1, John Dunning1, Martin Goddard1, Sai Bhagra1, Stephen Pettit1, Caitlin Cheshire1, Clive Lewis1, Anna Kydd1, Ayyaz Ali1, Catherine Sudarshan1, David Jenkins1, Steven Tsui1, Roger Hall1, Pedro Catarino1, Stephen R Large2.   

Abstract

BACKGROUND: In an effort to address the increasing demand for heart transplantation within the United Kingdom (UK), we established a clinical program of heart transplantation from donation after circulatory-determined death (DCD) donors in 2015. After 5 years, we report the clinical early outcomes and impact of the program.
METHODS: This is a single-center, retrospective, matched, observational cohort study comparing outcomes of hearts transplanted from DCD donors from March 1, 2015 to February 29, 2020 with those from matched donation after brain death (DBD) donors at Royal Papworth Hospital (RPH) (Cambridge, UK). DCD hearts were either retrieved using thoracoabdominal normothermic regional perfusion or the direct procurement and perfusion technique. All DBD hearts were procured using standard cold static storage. The primary outcomes were recipient 30-day and 1-year survival.
RESULTS: During the 5-year study, DCD heart donation increased overall heart transplant activity by 48% (79 for DCD and 164 for DBD). There was no difference in survival at 30 days (97% for DCD vs 99% for DBD, p = 1.00) or 1 year (91% for DCD vs 89% for DBD, p = 0.72). There was no difference in the length of stay in the intensive care unit (7 for DCD vs 6 for DBD days, p = 0.24) or in the hospital (24 for DCD vs 25 for DBD days, p = 0.84).
CONCLUSIONS: DCD heart donation increased overall heart transplant activity at RPH by 48%, with no difference in 30-day or 1-year survival in comparison with conventional DBD heart transplantations. DCD heart donation is set to make a dramatic difference in the number of patients who can benefit from heart transplantation.
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  circulatory death; direct procurement; donation; heart; normothermic regional perfusion; transplant

Year:  2020        PMID: 33248525     DOI: 10.1016/j.healun.2020.10.001

Source DB:  PubMed          Journal:  J Heart Lung Transplant        ISSN: 1053-2498            Impact factor:   10.247


  12 in total

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9.  Logistics for expanding heart transplantation from donation after circulatory death using normothermic regional perfusion.

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Journal:  JTCVS Tech       Date:  2022-01-21

10.  Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward.

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