Heart Transplant Donor Selection Guidelines: Review and Recommendations

Sathianathan, Shyama; Bhat, Geetha

doi:10.1007/s11886-021-01631-y

Cited by 10 publications

(7 citation statements)

References 71 publications

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“…Although those donors have been called marginal in the past, there are many recent studies confirming the good outcome of HTx with those donors. 3,[16][17][18][19] ISHLT registry data show that likewise with our centre's policy, acceptance of those donors has become frequent practice worldwide to increase the donor pool. 3 We reported shorter warm ischemia for the Group 2 than Group 1.…”

Section: Discussionmentioning

confidence: 95%

“…Same trends were found for concomitant diabetes mellitus of donors as well as drug abuse. Although those donors have been called marginal in the past, there are many recent studies confirming the good outcome of HTx with those donors 3,16–19 . ISHLT registry data show that likewise with our centre's policy, acceptance of those donors has become frequent practice worldwide to increase the donor pool 3 …”

Section: Discussionmentioning

confidence: 97%

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Heart transplantation in the era of corona virus disease 2019: Impact of the pandemic on donors, recipients and outcome

Immohr

Ballázs

Hettlich

et al. 2023

Clinical Transplantation

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Introduction Since March 2020, the COVID‐19 pandemic has tremendously impacted health care all around the globe. We analyzed the impact of the pandemic on donors, recipients, and outcome of heart transplantation (HTx). Methods Between 2010 and early 2022, a total of n = 235 patients underwent HTx in our department. Patients were assigned to the study groups regarding the date of the performed HTx. Group 1 (09/2010 to 02/2020): n = 160, Group 2 (03/2020 to 02/2022): n = 75. Results Since the pandemic, the etiology of heart failure in the recipients has shifted from dilated (Group 1: 53.8%, Group 2: 32.0%) to ischemic cardiomyopathy (Group 1: 39.4%, Group 2: 50.7%, p < .01). The percentage of high urgency status of the recipients dropped from 50.0% to 36.0% (p = .05), and the use of left ventricular assist (LVAD) support from 56.9% to just 37.3% (p < .01). Meanwhile, the waiting time for the recipients also decreased by about 40% (p = .05). Since the pandemic, donors were 2‐ times more likely to have been previously resuscitated (Group 1: 21.3%, Group 2: 45.3% (p < .01), and drug abuse increased by more than 3‐times (p < .01), indicating acceptance of more marginal donors. Surprisingly, the incidence of postoperative severe primary graft dysfunction requiring extracorporeal life support decreased from 33.1% to 19.4% (p = .04) since the pandemic. Conclusion The COVID‐19 pandemic affected both donors and recipients of HTX but not the postoperative outcome. Donors nowadays are more likely to suffer from ischemic heart disease and are less likely to be on the high‐urgency waitlist and on LVAD support. Simultaneously, an increasing number of marginal donors are accepted, leading to shorter waiting times.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 97%

Heart transplantation in the era of corona virus disease 2019: Impact of the pandemic on donors, recipients and outcome

Immohr

Ballázs

Hettlich

et al. 2023

Clinical Transplantation

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“… 19) Predictive risk models have been developed to optimize donor selection; however, they are not widely applicable or adopted in clinical practice. 20) …”

Section: Discussionmentioning

confidence: 99%

The Clinical Outcomes of Marginal Donor Hearts: A Single Center Experience

Lee

Kim

et al. 2023

Korean Circ J

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Author's summary This study aimed to report the outcomes of a single tertiary transplantation center that actively uses marginal donors (MDs). Consecutive 73 heart transplantation (HTx) cases were analyzed retrospectively and 43.8% of donor hearts met the MD criteria. There was no statistically significant difference in primary graft dysfunction (PGD), 30-day mortality and long-term survival between MD and non-MD groups. Notably, HTx using MDs in low-risk recipients showed excellent outcome. These results suggest appropriately selected donor hearts declined as MDs may increase organ utilization without an increase in post-transplant mortality or PGD.

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“…Compared to SCS and SherpaPak both, the OCS technology allows the preservation of the heart for a longer duration and significantly reduces the total cold ischemia time. The cold ischemia time in OCS is limited to the initial and final phases, i.e., from procurement to the connection of the heart to the OCS and from disconnecting the heart from the OCS to reperfusion after the organ transplant [26].…”

Section: Comparison Of Ocs To Scsmentioning

confidence: 99%

Is the Organ Care System (OCS) Still the First Choice With Emerging New Strategies for Donation After Circulatory Death (DCD) in Heart Transplant?

Alomari¹,

Garg²,

Yazji³

et al. 2022

Cureus

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The scarcity of donor hearts continues to be a challenge in transplants for advanced heart failure patients. With an increasing number of patients on the waiting list for a heart transplant, the discrepancy in the number between donors and recipients is gradually increasing and poses a new challenge that plagues the healthcare systems when it comes to the heart. Several technologies have been developed to expand the donor pool in recent years. One such method is the organ care system (OCS). The standard method of organ preservation is the static cold storage (SCS) method which allows up to four hours of safe preservation of the heart. However, beyond four hours of cold ischemia, the incidence of primary graft dysfunction increases significantly. OCS keeps the heart perfused close to the physiological state beyond the four hours with superior results, which allows us to travel further and longer distances, leading to expansion in the donor pool. In this review, we discuss the OCS system, its advantages, and shortcomings.

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Heart Transplant Donor Selection Guidelines: Review and Recommendations

Cited by 10 publications

References 71 publications

Heart transplantation in the era of corona virus disease 2019: Impact of the pandemic on donors, recipients and outcome

Heart transplantation in the era of corona virus disease 2019: Impact of the pandemic on donors, recipients and outcome

The Clinical Outcomes of Marginal Donor Hearts: A Single Center Experience

Is the Organ Care System (OCS) Still the First Choice With Emerging New Strategies for Donation After Circulatory Death (DCD) in Heart Transplant?

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