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A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Beating Heart Transplantation: How to Do It
Aravind Krishnan1, Brandon A Guenthart1, Chawannuch Ruaengsri1
1Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA, USA.
Insights
A novel beating heart implantation technique for deceased after circulatory death (DCD) donors eliminates cardioplegic arrest, potentially improving heart transplant outcomes. This method aims to match results from brain death donors, reducing ischemia and reperfusion injury.
Area of Science:
- Cardiovascular Surgery
- Organ Transplantation
- Donor Management
Background:
- Deceased after circulatory death (DCD) donors expand the organ donor pool for heart transplantation.
- Conventional DCD heart transplantation involves warm and cold ischemia, potentially impacting outcomes.
- Ex vivo normothermic perfusion is a key technology in utilizing DCD hearts.
Purpose of the Study:
- To introduce and detail a novel beating heart implantation technique for DCD heart transplantation.
- To eliminate the need for a second cardioplegic arrest and associated reperfusion injury.
- To hypothesize improved short-term and long-term outcomes comparable to brain death donor transplants.
Main Methods:
- Development of a beating heart implantation surgical technique.
- Application of the technique in deceased after circulatory death (DCD) heart transplantation.
- Focus on avoiding a second cardioplegic arrest during implantation.
Main Results:
- The developed technique successfully enables beating heart implantation.
- Eliminates the requirement for cardioplegic arrest and subsequent reperfusion injury.
- Provides a reproducible method for DCD heart transplantation.
Conclusions:
- The beating heart implantation technique offers a promising alternative for DCD heart transplantation.
- Potential to improve patient outcomes by mitigating ischemic injury.
- This method may help achieve outcomes similar to those from brain death donors.
Abstract:
Heart transplantation utilizing deceased after circulatory death (DCD) donors has expanded the donor pool through the use of ex vivo normothermic perfusion. Compared with brain death donation, the conventional method of performing DCD heart transplantation includes an additional period of warm and cold ischemia. We have developed a beating heart implantation technique that obliviates the need for a second cardioplegic arrest and the associated reperfusion injury. We hypothesize this reproducible method may improve short-term and long-term outcomes to mirror results seen in brain death donors and provide details on how to perform beating heart transplantation.
