• J. Heart Lung Transplant. · Dec 2017

    Observational Study

    Outcome after heart transplantation from donation after circulatory-determined death donors.

    • Simon Messer, Aravinda Page, Richard Axell, Marius Berman, Jules Hernández-Sánchez, Simon Colah, Barbora Parizkova, Kamen Valchanov, John Dunning, Evgeny Pavlushkov, Sendhil K Balasubramanian, Jayan Parameshwar, Yasir Abu Omar, Martin Goddard, Stephen Pettit, Clive Lewis, Anna Kydd, David Jenkins, Christopher J Watson, Catherine Sudarshan, Pedro Catarino, Marie Findlay, Ayyaz Ali, Steven Tsui, and Stephen R Large.
    • Department of Transplantation, Papworth Hospital National Health Service Foundation Trust, Papworth Everard, Cambridgeshire, United Kingdom.
    • J. Heart Lung Transplant. 2017 Dec 1; 36 (12): 1311-1318.

    BackgroundThe requirement for heart transplantation is increasing, vastly outgrowing the supply of hearts available from donation after brain death (DBD) donors. Transplanting hearts after donation after circulatory-determined death (DCD) may be a viable additive alternative to DBD donors. This study compared outcomes from the largest single-center experience of DCD heart transplantation against matched DBD heart transplants.MethodsDCD hearts were retrieved using normothermic regional perfusion (NRP) or direct procurement and perfusion (DPP). During NRP, perfusion was restored to the arrested heart within the donor with the exclusion of the cerebral circulation, whereas DPP hearts were removed directly. All hearts were maintained on machine perfusion during transportation. A retrospective cohort of DBD heart transplants, matched for donor and recipient characteristics, was used as a comparison group. The primary outcome measure of this study (set by the United Kingdom regulatory body) was 90-day survival.ResultsThere were 28 DCD heart transplants performed during the 25-month study period. Survival at 90 days was not significantly different between DCD and matched DBD transplant recipients (DCD, 92%; DBD, 96%; p = 1.0). Hospital length of stay, treated rejection episodes, allograft function, and 1-year survival (DCD, 86%; DBD, 88%; p = 0.98) were comparable between groups. The method of retrieval (NRP or DPP) was not associated with a difference in outcome.ConclusionsThese results suggest that heart transplantation from DCD heart donation provides comparable short-term outcomes to traditional DBD heart transplants and can serve to increase heart transplant activity in well-selected patients.Copyright © 2017 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…