Heart Transplantation from Donation After Circulatory Death Donors: An Update on the Australian Experience

Joshi, Yashutosh; Scheuer, Sarah; Soto, C.; Hwang, Bridget; Zhao, Chunlei; Chew, Hong Chee; Iyer, Arjun; Watson, Ash; Connellan, M.; Granger, Emily; Jansz, P.; Macdonald, P.

doi:10.1016/j.healun.2022.01.164

Cited by 1 publication

(3 citation statements)

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“…Whilst our initial ECMO rate was high, our ongoing use of the OCS Heart has enabled ongoing familiarisation with DPP techniques and an appreciation of the need to minimise aWIT. The ECMO rate in the subsequent 54 DCD heart transplants that have occurred since the initial series is now at 7% [24]. Despite our cold ischaemic time being significantly higher in this more contemporary cohort, this did not significantly impact ECMO rates and neither did significantly longer fWIT times.…”

Section: Ischaemic Times and Mechanical Supportmentioning

confidence: 67%

“…Preclinical work by our unit demonstrated NMP with the OCS Heart to be superior to CSS in a porcine DCD transplant model [21]. On the basis of these findings, in 2014, our unit performed the world's first series of distantly procured DCD donor heart transplants [23]; we have since performed 77 DCD heart transplants in Australia to date [24].…”

Section: Breakthroughs In Dcd Donor Heart Preservation Strategiesmentioning

confidence: 92%

“…To date in Australia, 77 DCD hearts have been successfully transplanted using the OCS Heart [24]. The approach to viability that we employed and would recommend considers the following criteria: (i.)…”

Section: Normothermic Machine Perfusionmentioning

confidence: 99%

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Donation After Circulatory Death: A New Frontier

et al. 2022

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Purpose of Review To highlight the current global experience with DCD heart transplantation and explore the evolution of, and compare preservation strategies; examine early clinical outcomes, and discuss the growing use of DCD donors as a new frontier in heart transplantation. Recent Findings The two strategies of DCD heart preservation include NMP using the OCS Heart and TA-NRP followed by either: NMP or CSS. Better understanding the limits of cold ischaemia following TA-NRP will aid in distant procurement. Asystolic warm ischaemia plays an important role in determining immediate post-operative graft function and potential need for mechanical support. Large volume DCD heart transplant units show no difference in survival between DCD and DBD donor heart transplants. Summary In a previously non-utilised source of donor hearts, often viewed as an “unknown frontier” in heart transplantation, DCD hearts are a suitable alternative to brain-dead donor hearts and are likely to remain a permanent part of the heart transplantation landscape. Global uptake is currently increasing, and as understanding of preservation strategies and tolerable ischaemic times improve, utilisation of DCD hearts will continue to grow.

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Section: Ischaemic Times and Mechanical Supportmentioning

confidence: 67%