The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
-
J. Heart Lung Transplant. · Jul 2013
A cardioprotective preservation strategy employing ex vivo heart perfusion facilitates successful transplant of donor hearts after cardiocirculatory death.
Ex vivo heart perfusion (EVHP) has been proposed as a means to facilitate the resuscitation of donor hearts after cardiocirculatory death (DCD) and increase the donor pool. However, the current approach to clinical EVHP may exacerbate myocardial injury and impair function after transplant. Therefore, we sought to determine if a cardioprotective EVHP strategy that eliminates myocardial exposure to hypothermic hyperkalemia cardioplegia and minimizes cold ischemia could facilitate successful DCD heart transplantation. ⋯ In this experimental model of DCD, an EVHP strategy using initial reperfusion with a tepid adenosine-lidocaine cardioplegia and continuous myocardial perfusion minimizes myocardial injury and improves short-term post-transplant function compared with the current EVHP strategy using cold hyperkalemic cardioplegia before organ procurement and transplantation.
-
J. Heart Lung Transplant. · Jul 2013
Use of a multiplex polymerase chain reaction system for enhanced bloodstream pathogen detection in thoracic transplantation.
Bloodstream infections (BSIs) constitute a frequent post-transplant complication in thoracic allograft recipients, especially during the early post-surgical period when patients are under intense immunosuppression. Thus, early and accurate identification of the responsible pathogens is of critical importance for patient survival. In this study we investigated the potential clinical utility of a multiplex real-time polymerase chain reaction (PCR) technology (SeptiFast; Roche Diagnostics) for the detection of BSIs in a cohort of thoracic allograft recipients. ⋯ The PCR-based SeptiFast test is a valuable addition to the traditional blood culture method for rapid etiologic diagnosis of BSIs in thoracic transplant recipients, especially during the early post-transplant period.