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Innovations in transplant techniques for complex anomalies

Katrien Vandendriessche1,2, Filip Rega1,2, Alexander Van De Bruaene2,3

  • 1Division of Cardiac Surgery, University Hospitals Leuven.

Current Opinion in Organ Transplantation
|August 9, 2024
PubMed

Insights

Innovations in heart transplantation, including machine perfusion and donation after circulatory death (DCD) donors, show promise for adult congenital heart disease (ACHD) patients. These techniques address critical time pressures and donor shortages in this growing population.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Congenital Heart Disease

Background:

  • The population of adult congenital heart disease (ACHD) patients is growing due to advances in surgical and medical management.
  • End-stage heart failure is a primary cause of mortality in ACHD patients, with increasing projections.
  • This review focuses on novel heart transplant strategies relevant to ACHD recipients.

Purpose of the Study:

  • To review recent innovations in heart transplant techniques.
  • To specifically address the application and implications of these innovations in the ACHD population.

Main Methods:

  • Review of current literature on heart transplantation innovations.
  • Focus on machine perfusion techniques (normothermic and hypothermic).
  • Evaluation of donation after circulatory death (DCD) strategies for heart procurement.

Main Results:

  • Machine perfusion (Organ Care System - OCS, Hypothermic Oxygenated Perfusion - HOPE) extends preservation times, potentially improving graft quality and donor-recipient matching.
  • Donation after circulatory death (DCD) heart transplantation, utilizing direct procurement-machine perfusion (DP-MP) or thoraco-abdominal normothermic regional perfusion (TA-NRP), offers a viable method to increase the donor pool.
  • These advancements can mitigate time constraints and expand donor availability for ACHD patients.

Conclusions:

  • Machine perfusion and DCD donors are feasible and promising for ACHD heart transplantation.
  • These innovations are particularly crucial for ACHD due to heightened time pressures and donor scarcity.
  • Further clinical studies are necessary to fully determine the impact of these techniques.
Abstract

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