Paediatric donation after circulatory determined death heart transplantation using donor normothermic regional perfusion and ex situ heart perfusion: A case report

Khushnood, Abbas; Butt, Tanveer; Jungschleger, J.; Henderson, Paul; Smith, Jonathan H.; Rita, Fabrizio De; Nassar, Mohamed; Page, A.; Messer, Simon; Large, Stephen; Dark, John H.; Parry, Gareth; Reinhardt, Zdenka; Hasan, Asif

doi:10.1111/petr.13536

Cited by 16 publications

(12 citation statements)

References 18 publications

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“…There are also increasing reports of the use of an ex vivo heart perfusion system to preserve donor hearts during transport . There is a case report of the successful use of this system in a child DCD to a child heart transplant recipient . The system is limited to donors who are at least 40 kg and is not yet approved by the FDA in the USA for general use, but holds promise for increasing donor supply.…”

Section: Discussionmentioning

confidence: 99%

Pediatric cardiac waitlist mortality—Still too high

Denfield

Azeka²,

Das

et al. 2020

Pediatric Transplantation

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Cardiac transplantation for children with end‐stage cardiac disease with no other medical or surgical options is now standard. The number of children in need of cardiac transplant continues to exceed the number of donors considered “acceptable.” Therefore, there is an urgent need to understand which recipients are in greatest need of transplant before becoming “too ill” and which “marginal” donors are acceptable in order to reduce waitlist mortality. This article reviewed primarily pediatric studies reported over the last 15 years on waitlist mortality around the world for the various subgroups of children awaiting heart transplant and discusses strategies to try to reduce the cardiac waitlist mortality.

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Section: Discussionmentioning

confidence: 99%

Pediatric cardiac waitlist mortality—Still too high

Denfield

Azeka²,

Das

et al. 2020

Pediatric Transplantation

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“…18 The use of TA-NRP remains geographically restricted within the UK while further local experience in perfecting the technique is gained. Although several units across the world have replicated TA-NRP, 19 including for pediatric heart transplant recipients, 20,21 it must be borne in mind that additional personnel (6 in total), extra equipment, and expertise are required. Clearly, if the benefits of both techniques could be included in one, with rapid reperfusion and ex situ functional assessment, allowing lactate to be disregarded, then potentially more hearts could be accepted for transplantation with possibly better outcomes.…”

Section: Figurementioning

confidence: 99%

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

Messer

Cernic

Page

et al. 2020

The Journal of Heart and Lung Transplantation

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179

161

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BACKGROUND: In an effort to address the increasing demand for heart transplantation within the United Kingdom (UK), we established a clinical program of heart transplantation from donation after circulatory-determined death (DCD) donors in 2015. After 5 years, we report the clinical early outcomes and impact of the program. METHODS: This is a single-center, retrospective, matched, observational cohort study comparing outcomes of hearts transplanted from DCD donors from March 1, 2015 to February 29, 2020 with those from matched donation after brain death (DBD) donors at Royal Papworth Hospital (RPH) (Cambridge, UK). DCD hearts were either retrieved using thoracoabdominal normothermic regional perfusion or the direct procurement and perfusion technique. All DBD hearts were procured using standard cold static storage. The primary outcomes were recipient 30-day and 1-year survival. RESULTS: During the 5-year study, DCD heart donation increased overall heart transplant activity by 48% (79 for DCD and 164 for DBD). There was no difference in survival at 30 days (97% for DCD vs 99% for DBD, p = 1.00) or 1 year (91% for DCD vs 89% for DBD, p = 0.72). There was no difference in the length of stay in the intensive care unit (7 for DCD vs 6 for DBD days, p = 0.24) or in the hospital (24 for DCD vs 25 for DBD days, p = 0.84). CONCLUSIONS: DCD heart donation increased overall heart transplant activity at RPH by 48%, with no difference in 30-day or 1-year survival in comparison with conventional DBD heart transplantations.

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“…A case report has also described a child who underwent successful heart transplantation after DCD. 17 …”

Section: Discussionmentioning

confidence: 99%

The Waiting List Mortality of Pediatric Heart Transplantation Candidates in Korea before the Pediatric Ventricular Assist Device Era

et al. 2021

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Background Despite advancements in heart transplantation for pediatric patients in Korea, the waiting list mortality has not been reported. Therefore, we investigated the waiting list mortality rate and factors associated with patient mortality. Methods We reviewed the medical records of pediatric patients who were registered for heart transplantation at three major hospitals in Korea from January 2000 to January 2020. All patients who died while waiting for heart transplantation were investigated, and we identified the waiting list mortality rate, causes of mortality and median survival periods depending on the variable risk factors. Results A total of 145 patients received heart transplantations at the three institutions we surveyed, and the waiting list mortality rate was 26%. The most common underlying diseases were cardiomyopathy (66.7%) and congenital heart disease (30.3%). The leading causes that contributed to death were heart failure (36.3%), multi-organ failure (27.2%), and complications associated with extracorporeal membrane oxygenation (ECMO) (25.7%). The median survival period was 63 days. ECMO was applied in 30 patients. The different waiting list mortality percentages according to age, cardiac diagnosis, use of ECMO, and initial Korean Network of Organ Sharing (KONOS) level were determined using univariate analysis, but age was the only significant factor associated with waiting list mortality based on a multivariate analysis. Conclusion The waiting list mortality of pediatric heart transplantation candidates was confirmed to be considerably high, and age, underlying disease, the application of ECMO, and the initial KONOS level were the factors that influenced the survival period.

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Paediatric donation after circulatory determined death heart transplantation using donor normothermic regional perfusion and ex situ heart perfusion: A case report

Cited by 16 publications

References 18 publications

Pediatric cardiac waitlist mortality—Still too high

Pediatric cardiac waitlist mortality—Still too high

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

The Waiting List Mortality of Pediatric Heart Transplantation Candidates in Korea before the Pediatric Ventricular Assist Device Era

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