• J. Thorac. Cardiovasc. Surg. · Dec 2024

    Rise of the Machines - Normothermic Regional Perfusion Use in Heart Transplantation in the United States.

    • Doug A Gouchoe, Divyaam Satija, Ervin Y Cui, Jacob N Schroder, Carmelo A Milano, Muath Bishawi, Ammu V Alvarez, Kukbin Choi, Matthew C Henn, Brent C Lampert, Nahush A Mokadam, Bryan A Whitson, and Asvin M Ganapathi.
    • Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH; COPPER Lab, The Ohio State University, Columbus, OH.
    • J. Thorac. Cardiovasc. Surg. 2024 Dec 9.

    ObjectiveRecently, normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP) have allowed for heart transplantation following donation after circulatory death (DCD). This study aimed to characterize utilization and variation of NRP and DPP in the United States.MethodsHeart transplants from 12/1/19-3/31/24 were identified from the United Network for Organ Sharing Database. DPP and NRP procurements were classified based on previously published methods. The groups were compared, and survival was assessed using Kaplan-Meier methods. Geographic and center variability was categorized using encrypted data.ResultsThere were 595 NRP transplants and 625 DPP transplants. Distance traveled and out of body time were significantly less for the NRP group (p<0.01 for both). There were no significant differences in post-operative dialysis, stroke or 1-year survival between groups, however post-operative pacemaker placement was higher with NRP (p<0.05). From 2019 to 2024, 54/61 centers (88.5%) used NRP, 50/61 centers (82%) used DPP, and 43/61 centers (70.5%) used both procurement techniques, with NRP currently being the most popular DCD procurement technique. Geographically, recipients from regions 2, 5 and 8 used NRP with greatest frequency, while those in regions 1, 3 and 10 used DPP with greatest frequency.ConclusionNRP use is rising within the United States, with tremendous growth since its inception a few years ago. Significant variation still exists regarding utilization of NRP and DPP and further determination of the impact of each procurement and preservation strategy on transplantation outcomes is necessary.Copyright © 2024. Published by Elsevier Inc.

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