A 5-year single-center early experience of heart transplantation from donation after circulatory-determined death donors

Messer, Simon; Cernic, Sendi; Page, A.; Berman, Marius; Kaul, Pratibha; Colah, Simon; Ali, Jason M.; Pavlushkov, E.; Baxter, Jen; Quigley, R.; Osman, Mohamed; Nachum, Eyal; Parameshwar, Jayan; Abu‐Omar, Yasir; Dunning, John; Goddard, Martin; Bhagra, Sai; Pettit, Stephen; Cheshire, Caitlin; Lewis, Clive; Kydd, Anna; Ali, Ayyaz; Sudarshan, Catherine; Jenkins, David P.; Tsui, Steven; Hall, Roger K.; Catarino, Pedro; Large, Stephen

doi:10.1016/j.healun.2020.10.001

Cited by 157 publications

(139 citation statements)

References 17 publications

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“…Similar outcomes have been reported from the higher volume program at Papworth Hospital, which reported on its first 79 cDCDD heart transplants with a 30-day survival of 97% vs 99% for the matched DNDD cohort. In the cDCDD heart transplant group, no significant differences in survival were found between 22 recipients included in the NRP protocol and 57 in the rapid recovery protocol [65].…”

Section: Ex Situ Heart Perfusion and Repairmentioning

confidence: 82%

“…cDCDD heart transplantation has become part of standard practice of care in the few pioneering centers in Australia and the UK. Their excellent results at medium term [62,65] and the recent commencement of similar programs in North America and continental Europe should broaden and accelerate the uptake of cDCDD heart transplantation.…”

Section: Ex Situ Heart Perfusion and Repairmentioning

confidence: 95%

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Expanding controlled donation after the circulatory determination of death: statement from an international collaborative

et al. 2021

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A decision to withdraw life-sustaining treatment (WLST) is derived by a conclusion that further treatment will not enable a patient to survive or will not produce a functional outcome with acceptable quality of life that the patient and the treating team regard as beneficial. Although many hospitalized patients die under such circumstances, controlled donation after the circulatory determination of death (cDCDD) programs have been developed only in a reduced number of countries. This International Collaborative Statement aims at expanding cDCDD in the world to help countries progress towards self-sufficiency in transplantation and offer more patients the opportunity of organ donation. The Statement addresses three fundamental aspects of the cDCDD pathway. First, it describes the process of determining a prognosis that justifies the WLST, a decision that should be prior to and independent of any consideration of organ donation and in which transplant professionals must not participate. Second, the Statement establishes the permanent cessation of circulation to the brain as the standard to determine death by circulatory criteria. Death may be declared after an elapsed observation period of 5 min without circulation to the brain, which confirms that the absence of circulation to the brain is permanent. Finally, the Statement highlights the value of perfusion repair for increasing the success of cDCDD organ transplantation. cDCDD protocols may utilize either in situ or ex situ perfusion consistent with the practice of each country. Methods to accomplish the in situ normothermic reperfusion of organs must preclude the restoration of brain perfusion to not invalidate the determination of death.

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Section: Ex Situ Heart Perfusion and Repairmentioning

confidence: 82%

Section: Ex Situ Heart Perfusion and Repairmentioning

confidence: 95%

Expanding controlled donation after the circulatory determination of death: statement from an international collaborative

et al. 2021

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“…However, hepatitis C positive donors currently only account for 1.1% of donors in the International Society of Heart and Lung Transplantation registry, and DCD‐HTX remains to be exclusively performed by specialized centers. Therefore, these donors currently do not account for substantial percentages of transplant activity in the United States or in Europe [17,26]. Fourth, the anonymized nature of the datasets underlying this retrospective registry analysis limited the possibilities to perform structured audits for data entry errors.…”

Section: Discussionmentioning

confidence: 99%

The adapted Heart Donor Score

et al. 2021

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Summary The Heart Donor Score (HDS) predicts donor organ discard for medical reasons and survival after heart transplantation (HTX) in the Eurotransplant allocation system. Our aim was to adapt the HDS for application in the United Network for Organ Sharing (UNOS) registry. To adjust for differences between the Eurotransplant and UNOS registries, the “adapted HDS” was created (aHDS) by exclusion of the covariates “valve function,” “left‐ventricular hypertrophy,” and exclusion of “drug abuse” from the variable “compromised history.” Two datasets were analyzed to evaluate associations of the aHDS with donor organ discard (n = 70 948) and survival (n = 19 279). The aHDS was significantly associated with donor organ discard [odds ratio 2.72, 95% confidence interval (CI) 2.68–2.76, P < 0.001; c‐statistic: 0.937). The score performed comparably in donors <60 and ≥60 years of age. The aHDS was a significant predictor of survival as evaluated by univariate Cox proportional hazards analysis (hazard ratio 1.04, 95% CI 1.01–1.07, P = 0.023), although the association lost significance in a multivariable model. The aHDS predicts donor organ discard. Negative effects of most aHDS components on survival are likely eliminated by highly accurate donor selection processes.

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“…Messer et al 27 published their experience with 79 DCD HTxs in Cambridge, United Kingdom. This was a retrospective, matched, observation cohort of HTxs from March 2015 through February 2020.…”

Section: Heart Transplantationmentioning

confidence: 99%

The Year 2020 in Review: Noteworthy Literature for Thoracic Transplant Anesthesiologists

Abrams

Wilkey

2021

Semin Cardiothorac Vasc Anesth

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The year 2020 was a monumental year in medicine, and this review focuses on selected articles for cardiothoracic anesthesiologists and perioperative physicians involved in the care of heart and lung transplant patients. In the field of lung transplantation, significant strides were made in our knowledge of risk stratification during the preoperative assessment of potential recipients, perioperative transfusion medicine, and the administration of coagulation factor concentrates. In addition, variations in perioperative management and outcomes between institutions were studied across an assortment of metrics regarding lung transplantation, including case volumes and anesthetic practices. Transitioning to topics in the field of heart transplantation, consideration was given to recipients with adult congenital heart disease, and separately, approaches to expanding the donor pool through donation after circulatory death. With regard to preoperative support, outcomes for the total artificial heart as well as the MitraClip as bridges to transplantation were published.

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A 5-year single-center early experience of heart transplantation from donation after circulatory-determined death donors

Cited by 157 publications

References 17 publications

Expanding controlled donation after the circulatory determination of death: statement from an international collaborative

Expanding controlled donation after the circulatory determination of death: statement from an international collaborative

The adapted Heart Donor Score

The Year 2020 in Review: Noteworthy Literature for Thoracic Transplant Anesthesiologists

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