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Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
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Beating Heart Transplant Procedures Using Organs From Donors With Circulatory Death
Aravind Krishnan1, Chawannuch Ruaengsri1, Brandon A Guenthart1
1Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California.
JAMA Network Open
|March 11, 2024
Summary
The beating heart method for deceased donor (DCD) heart transplants is safe, showing zero need for extracorporeal membrane oxygenation post-surgery. This technique may reduce ischemia reperfusion injury, improving outcomes for DCD heart transplantation.
Area of Science:
- Cardiovascular Surgery
- Transplantation Immunology
- Organ Preservation
Background:
- Deceased after circulatory death (DCD) donors are increasingly used for heart transplantation.
- Ex vivo normothermic organ perfusion enables DCD heart use but involves ischemia, potentially increasing graft injury.
- High rates of extracorporeal membrane oxygenation (ECMO) are observed post-DCD heart transplant.
Purpose of the Study:
- To evaluate the safety of the beating heart method for DCD heart transplantation.
- To assess the postoperative rate of extracorporeal membrane oxygenation (ECMO) use in DCD heart transplantation using this technique.
Main Methods:
- A case series of 10 patients undergoing DCD heart transplantation using the beating heart implantation method.
- Data collected from October 2022 to August 2023 at a single academic medical center.
- Analysis focused on primary graft dysfunction and need for mechanical circulatory support.
Main Results:
- All 10 patients survived with 100% graft survival.
- No patients required postoperative extracorporeal membrane oxygenation (ECMO) or other mechanical circulatory support.
- The mean age of recipients was 51.2 years, with 70% having idiopathic dilated cardiomyopathy.
Conclusions:
- The beating heart implantation method for DCD heart transplantation is safe and effective.
- This technique may mitigate ischemia reperfusion injury, potentially reducing primary graft dysfunction and ECMO requirement.
- Findings are relevant for centers utilizing DCD donors for heart transplantation.
