Journal
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
Volume 29, Issue 3, Pages 422-429Publisher
OXFORD UNIV PRESS
DOI: 10.1093/icvts/ivz121
Keywords
Donation after circulatory-determined death (DCD); Heart transplantation; TransMedicsVR; Organ Care System (OCS)
Funding
- New Start Charity -The Wythenshawe Hospital Transplant Fund
Ask authors/readers for more resources
OBJECTIVES: Demand for heart transplant donors worldwide continues to outstrip supply. Transplanting hearts following donation after circulatory-determined death (DCD) is increasingly recognized as a safe and effective alternative. As the fourth centre worldwide to have established such a programme, our goal was to present our initial experience. METHODS: This was a single-centre retrospective observational study. All DCD hearts were retrieved using direct procurement and perfusion. Continuous normothermic perfusion of the procured heart was then established on the TransMedicsVR Organ Care System. The primary outcome of this study was the 30-day survival rate. RESULTS: Between May 2017 and December 2018, 8 DCD hearts were procured and 7 were subsequently implanted, including in 2 patients who had left ventricular assist devices explanted. During the same time period, 30 patients received donation after brainstem death heart transplants. Therefore, the DCD heart transplant programme led to a 23% increase in transplant activity. The median donation warm ischaemic time was 34 min [interquartile range (IQR) 31-39 min]. The median functional warm ischaemic time was 28 min (IQR 2530 min). The median time spent by the organ on the Organ Care System was 263 min (IQR 242-296 min). The overall 30-day survival rate was 100% and the 90-day survival rate was 86%. Postoperative extracorporeal membrane oxygenation was required in 3/7 (43%). CONCLUSIONS: DCD heart transplants can lead to a 23% increase in heart transplant activity and should be adopted by more institutions across the world. Already established transplant programmes with good early outcomes can start such a programme safely.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available