The Annals of Thoracic Surgery, Год журнала: 2024, Номер 118(6), С. 1299 - 1307
Опубликована: Авг. 14, 2024
Язык: Английский
Circulation Heart Failure, Год журнала: 2024, Номер 17(7)
Опубликована: Июнь 20, 2024
Orthotopic heart transplant is the gold standard therapeutic intervention for patients with end-stage failure. Conventionally, has relied on donation after brain death organ recovery. Donation circulatory (DCD) of confirming that function irreversibly ceased. DCD-orthotopic differs from death-orthotopic in ways carry implications widespread adoption, including differences recovery, storage and ethical considerations surrounding normothermic regional perfusion DCD. Despite these differences, DCD shown promising early outcomes, augmenting donor pool allowing more individuals to benefit orthotopic transplant. This review aims present current state future trajectory DCD-heart transplant, examine key between death, clinical experiences innovations methodologies, address ongoing challenges new frontier donors.
Язык: Английский
Процитировано
5
Current Cardiology Reports, Год журнала: 2024, Номер unknown
Опубликована: Окт. 9, 2024
Abstract Purpose of Review To summarise current international clinical outcomes from donation after circulatory death heart transplantation (DCD-HT); discuss procurement strategies, their impact on and overall organ procurement; identify novel approaches future areas for research in DCD-HT. Recent Findings Globally, DCD-HT survival (regardless strategy) are comparable to brain dead donors (BDD). Experience with normothermic machine perfusion sees improvement rates primary graft dysfunction. Techniques have evolved reduce cold ischaemic exposure directly procured DCD hearts, though controlled periods ischaemia can likely be tolerated. There is interest hypothermic (HMP) promising early results. Summary Survival firmly established equivalent between BDD Procurement strategy (direct vs. regional perfusion) remains a source debate. Methods improve allograft warm tolerance will key the uptake HMP hearts.
Язык: Английский
Процитировано
4
Transplant International, Год журнала: 2025, Номер 38
Опубликована: Фев. 14, 2025
Heart transplant for adults following Donation after Circulatory Death (DCD) is well established in many parts of the world, including United Kingdom (UK). Small child DCD hearts have now been recovered UK and internationally utilising novel technologies. Despite these recent advances, extension this practice to pediatric cardiac transplantation has slow difficult despite severe shortage donors children leading a high number deaths annually waiting heart transplant. This direct contrast with thriving programme adult donation non-cardiac organs. There insufficient action addressing inequality thus far. Barriers development are multifaceted: ethical concerns, technological paucity, financial logistical hurdles. We describe background, live issues, current developments how we driving resources toward sustainable small provide valuable insights other countries elements principles at play. call responsible bodies take urgent achievable actions establish an equitable paediatric donors, recipients their families.
Язык: Английский
Процитировано
0
American Journal of Transplantation, Год журнала: 2025, Номер unknown
Опубликована: Фев. 1, 2025
Язык: Английский
Процитировано
0
Clinical Transplantation, Год журнала: 2025, Номер 39(3)
Опубликована: Март 1, 2025
ABSTRACT Introduction Use of normothermic regional perfusion (NRP) to recover donation after circulatory death (DCD) organs demonstrates increased heart utilization with favorable outcomes. Conversely, DCD lung allograft use when NRP was employed remains controversial. This is a contemporary analysis recipient outcomes in which used. Methods Utilizing the STAR‐OPTN database, all adult recipients United States between January 1, 2020, and June 30, 2024 were identified. defined if time donor aortic clamp greater than 30 min. Recipient outcomes, including 30‐, 60‐, 90‐day mortality, grade‐3 primary graft dysfunction (PGD), postoperative length stay compared using multivariable logistic regression controlling for covariates. Survival performed Cox proportional hazard modeling. Results Of 987 transplants, 92 (9.4%) utilized NRP. There no differences characteristics direct recovery cohorts. No difference or PGD, found 12‐month survival equivalent. Conclusions Outcomes equivalent recipients. Thus, lungs may be considered transplantation following procedures.
Язык: Английский
Процитировано
0
The Journal of Heart and Lung Transplantation, Год журнала: 2024, Номер 43(7), С. 1196 - 1197
Опубликована: Март 21, 2024
Язык: Английский
Процитировано
3
American Journal of Transplantation, Год журнала: 2024, Номер unknown
Опубликована: Сен. 1, 2024
Язык: Английский
Процитировано
3
Transplantology, Год журнала: 2025, Номер 6(2), С. 11 - 11
Опубликована: Апрель 17, 2025
The growing disparity between the demand for donor hearts and their availability has reignited interest in donation after circulatory death (DCD) heart transplantation. Historically, DCD transplantation been overshadowed by brain (DBD) due to ethical preservation challenges. However, recent advancements procurement techniques allow evaluation of enable broader utilization donors. While challenges remain, early outcomes suggest comparable survival rates DBD This review provides a comprehensive overview historical evolution, current practices, future directions Here, we emphasize its potential expand pool alleviate organ shortage crisis.
Язык: Английский
Процитировано
0
Journal of Thoracic and Cardiovascular Surgery, Год журнала: 2025, Номер unknown
Опубликована: Май 1, 2025
To clarify the association between warm ischemic time during donation after circulatory death (DCD) and severe primary graft dysfunction (PGD) heart transplant. DCD transplants using normothermic regional perfusion, excluding congenital etiology or multiorgan transplant, at a single institution from January 2020 to December 2024 were reviewed. Donation withdrawal (DWIT), functional time, defined by oxygen saturation <80% (FWIT O2), systolic blood pressure <80 mm Hg <50 Hg, asystolic examined. Propensity matching created balanced cohorts associate ischemia outcomes. Outcomes included incidence of PGD, lengths stay, mortality. The final study cohort had 135 patients, whom 10 (7.4%) PGD. When stratified donor recipient demographics similar. DWIT (median 25.0 minutes vs 35.5 minutes, P = .031) FWIT O2 22.0 33.0 .025) lower in those without Logistic regression identified as better predictor compared with DWIT. Receiver operating characteristic curve analysis threshold 23 (area under curve, 0.714). After matching, rates PGD significantly greater >23 group (8/59 [13.6%] 1/59 [1.7%], .032). However, similar stay In perfusion is associated increased was not other outcomes, including Rejection allografts on basis prolonged may lead unnecessary discard viable hearts.
Язык: Английский
Процитировано
0
The Journal of Heart and Lung Transplantation, Год журнала: 2025, Номер unknown
Опубликована: Май 1, 2025
Язык: Английский
Процитировано
0