Excellent Long-Term Survival with Extended Ischemic Time in Orthotopic Heart Transplantation

Smith, Jason W.; O’Brien, Kevin D.; Dardas, Todd; Fishbein, Daniel P.; Verrier, Edward D.; Stempien‐Otero, April; Cheng, Richard K.; Masri, S.C.; Buchter, Carol; Aldea, Gabriel S.; Levy, Wayne C.; Mokadam, Nahush A.

doi:10.1016/j.healun.2014.01.033

Cited by 2 publications

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“…[21][22][23] Cardiopulmonary resuscitation in donors with return to normal function has not demonstrated adverse outcomes, and longer total ischemic time may be more acceptable than previously thought. [24][25][26] The impact of left ventricular hypertrophy on donor quality is also facing scrutiny, and may be less restrictive than historically assumed. 27 Although the changes in the use of donor organs with each of these individual high-risk donor characteristics were not statistically significant at our center, the vector of change was in the direction of using more of these organs, which we feel accounts for the behavioral adaptation that has led to increased transplant volumes.…”

Section: Discussionmentioning

confidence: 99%

Systematic donor selection review process improves cardiac transplant volumes and outcomes

Smith

O’Brien

Dardas

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Systematic donor selection review process improves cardiac transplant volumes and outcomes

Smith

O’Brien

Dardas

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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“…Regardless of commercially available heart preservation solution used, the results of static cold storage are optimal when ischemic times are less than 4–6 h. After this timepoint, risk of posttransplant primary graft failure and death increases significantly [ 12 , 32 , 42 , 43 , 44 ]. Though some centers have reported acceptable outcomes with ischemic times >6 h [ 45 , 46 ], these results may only be applicable to very carefully selected donor-recipient pairs.…”

Section: Current Methods Of Heart Preservationmentioning

confidence: 99%

Heart Donation and Preservation: Historical Perspectives, Current Technologies, and Future Directions

Hess

Ziegler

Kaczorowski

2022

JCM

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Heart transplantation has become the accepted treatment for advanced heart failure, with over 4000–5000 performed in the world annually. Although the number of yearly transplants performed has been increasing over the last decade, the number of candidates in need of transplantation continues to grow at an even faster rate. To distribute these scarce and precious resources equitably, donor heart placement is based on clinical need with priority given to those who are more critically ill. As a result, donors are matched with recipient candidates over increasingly farther distances, which may subject these organs to longer ischemic times. One of the mainstays of successful heart transplantation is successful organ preservation while the donor organ is ex vivo from the time of donor procurement to recipient implantation. In order to adapt to a new era of heart transplantation where organs are shared across wider ranges, preservation strategies must evolve to accommodate longer ischemia times while mitigating the harmful sequalae of ischemia-reperfusion injury. Additionally, in order to address the ever-growing supply demand mismatch of donor organs, evolving perfusion technologies may allow for further evaluation of donor grafts outside of conventional acceptance practices, thus enlarging the effective donor pool. Herein this review, we discuss the history of organ preservation, current strategies and modalities employed in current practice, along with developing technologies in preclinical stages. Lastly, we introduce the concept of donation after circulatory death (DCD), which has been until recently a largely unexplored avenue of heart donation that relies much on current preservation techniques.

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Excellent Long-Term Survival with Extended Ischemic Time in Orthotopic Heart Transplantation

Cited by 2 publications

References 0 publications

Systematic donor selection review process improves cardiac transplant volumes and outcomes

Systematic donor selection review process improves cardiac transplant volumes and outcomes

Heart Donation and Preservation: Historical Perspectives, Current Technologies, and Future Directions

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