Adult heart transplantation with distant procurement and ex-vivo preservation of donor hearts after circulatory death: a case series

Dhital, K.; Iyer, Arjun; Connellan, M.; Chew, Hong Chee; Gao, Ling; Doyle, Aoife; Hicks, Mark; Kumarasinghe, G.; Soto, C.; Dinale, Andrew; Cartwright, Bruce; Nair, Priya; Granger, Emily; Jansz, P.; Jabbour, Andrew; Kotlyar, Eugene; Keogh, Anne; Hayward, Christopher; Graham, Robert M.; Spratt, Phillip; Macdonald, Peter S.

doi:10.1016/s0140-6736(15)60038-1

Cited by 346 publications

(261 citation statements)

References 26 publications

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“…Furthermore, this did not allow for functional assessment of the heart following the hypoxic insult of circulatory death till after implantation in the recipient However, wider acceptance of DCD heart donation was reported in 2015 following the transplantation of three adult DCD hearts in Sydney using direct procurement and perfusion (DPP) (18). This technique involves removing the asystolic heart and reanimating the organ upon an ex-situ perfusion platform [TransMedics Organ Care System (OCS), Andover, MA, USA)] (19).…”

Section: The History Of Human Dcd Heart Donationmentioning

confidence: 99%

Heart transplantation from donation after circulatory determined death

Page¹,

Messer²,

Large³

2018

Ann. Cardiothorac. Surg.

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Fifty years since the first successful human heart transplant from a non-heart beating donor, this concept of heart transplantation from donation after circulatory determined death (DCD) promises to be one of the most exciting developments in heart transplantation. Heart transplantation has established itself as the best therapeutic option for patients with end-stage heart failure, with the opportunity to provide these patients with a near-normal quality of life. However, this treatment is severely limited by the availability of suitable donor hearts. In recent times, heart transplantation has been limited to using donor hearts from donors following brain stem death. The use of donor hearts from DCD had been thought to be associated with high risk and poor outcomes until recent developments in organ perfusion and retrieval techniques have shown that this valuable resource may provide an answer to the global shortage of suitable donor hearts. With established DCD heart transplant programmes reporting encouraging results, this technique has been shown to be comparable to the current gold standard of donation after brain death (DBD) heart transplantation.

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Section: The History Of Human Dcd Heart Donationmentioning

confidence: 99%

Heart transplantation from donation after circulatory determined death

Page¹,

Messer²,

Large³

2018

Ann. Cardiothorac. Surg.

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“…Interestingly, a similar time window (30 min) was recently validated using dead-body donor hearts for transplantation (Dhital et al 2015).…”

Section: Quality Control Of the Sydney Heart Bank Samplesmentioning

confidence: 93%

The Sydney Heart Bank: improving translational research while eliminating or reducing the use of animal models of human heart disease

Remedios

Lal

et al. 2017

Biophys Rev

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The Sydney Heart Bank (SHB) is one of the largest human heart tissue banks in existence. Its mission is to provide high-quality human heart tissue for research into the molecular basis of human heart failure by working collaboratively with experts in this field. We argue that, by comparing tissues from failing human hearts with age-matched non-failing healthy donor hearts, the results will be more relevant than research using animal models, particularly if their physiology is very different from humans. Tissue from heart surgery must generally be used soon after collection or it significantly deteriorates. Freezing is an option but it raises concerns that freezing causes substantial damage at the cellular and molecular level. The SHB contains failing samples from heart transplant patients and others who provided informed consent for the use of their tissue for research. All samples are cryopreserved in liquid nitrogen within 40 min of their removal from the patient, and in less than 5-10 min in the case of coronary arteries and left ventricle samples. To date, the SHB has collected tissue from about 450 failing hearts (>15,000 samples) from patients with a wide range of etiologies as well as increasing numbers of cardiomyectomy samples from patients with hypertrophic cardiomyopathy. The Bank also has hearts from over 120 healthy This article is part of a Special Issue on 'IUPAB Edinburgh Congress' edited by Damien Hall.Electronic supplementary material The online version of this article

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“…Dhital and colleagues published their feasibility series of three DCD hearts in 2015. They used a technique of direct procurement and perfusion with the TransMedics OCS system (42). The following year, Messer and colleagues also demonstrated success with DCD hearts.…”

Section: Ex Vivo Preservationmentioning

confidence: 99%

The future of cardiac transplantation

Koomalsingh¹,

Kobashigawa²

2018

Ann. Cardiothorac. Surg.

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The first human-to-human heart transplant was performed 50 years ago in 1967. Heart transplantation has now entered an era of tremendous growth and innovation. The future of heart transplantation is bright with the advent of newer immunosuppressive medications and strategies that may even result in tolerance.Much of this progress in heart transplant medicine is predicated on a better understanding of acute and chronic rejection pathways through basic science studies. The future will also include personalized medicine where genomics and molecular science will dictate customized treatment for optimal outcomes. The introduction of mechanical circulatory support (MCS) devices has changed the landscape for patients with severe heart failure to stabilize the most ill patient and make them better candidates for heart transplant.As ex vivo preservation takes hold, we may witness an expansion of the donor pool through the use of donation after cardiac death (DCD) donors. In addition, further geographical donor heart sharing through ex vivo preservation may further decrease waitlist mortality by enabling longer distance donor hearts to be allocated for the sickest waitlist patient. It is no doubt an exciting time to be involved in the field of heart transplantation. In this perspective, we will summarize the present state of heart transplantation and discuss various innovations that are being pursued.

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Adult heart transplantation with distant procurement and ex-vivo preservation of donor hearts after circulatory death: a case series

Cited by 346 publications

References 26 publications

Heart transplantation from donation after circulatory determined death

Heart transplantation from donation after circulatory determined death

The Sydney Heart Bank: improving translational research while eliminating or reducing the use of animal models of human heart disease

The future of cardiac transplantation

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