DCD donations and outcomes of heart transplantation: the Australian experience
| العنوان: | DCD donations and outcomes of heart transplantation: the Australian experience |
|---|---|
| المؤلفون: | Kumud Dhital, Peter S. Macdonald, Sarah E. Scheuer, Prakash Ludhani, Mark Connellan |
| المصدر: | Indian J Thorac Cardiovasc Surg |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, Heart transplantation, medicine.medical_specialty, business.industry, medicine.medical_treatment, Review Article, 030204 cardiovascular system & hematology, Vascular surgery, medicine.disease, Circulatory death, Cardiac surgery, Surgery, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Cardiothoracic surgery, Donation, Internal medicine, Heart failure, Cohort, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business |
| الوصف: | PURPOSE: There is increasing clinical utilization of hearts from the donation after circulatory death (DCD) pathway with the aim of expanding the donor pool and mitigating the ever-present discrepancy between the inadequate availability of good quality donor hearts and the rising number of patients with end-stage heart failure. METHODS: This article reviews the rationale, practice, logistical factors, and 5-year experience of DCD heart transplantation at St Vincent’s Hospital, Sydney. FINDINGS: Between July 2014 and July 2019, 69 DCD donor retrievals were undertaken resulting in 49 hearts being instrumented on an ex situ normothermic cardiac perfusion device. Seventeen (35%) of these hearts were declined and the remaining 32 (65%) were used for orthotopic DCD heart transplantation. At 5 years of follow-up, the 1-, 3-, and 5-year survival was 96%, 94%, and 94% for DCD hearts compared with 89%, 83%, and 82% respectively for donation after brain death (DBD) hearts (n.s). The immediate post-implant requirement for temporary extra-corporeal membrane oxygenation (ECMO) support for delayed graft function was 31% with no difference in rejection rates when compared with the contemporaneous cohort of patients transplanted with standard criteria DBD hearts. SUMMARY: DCD heart transplantation has become routine and incorporated into standard clinical practice by a handful of pioneering clinical transplant centres. The Australian experience demonstrates that excellent medium-term outcomes are achievable from the use of DCD hearts. These outcomes are consistent across the other centres and consequently favour a more rapid and wider uptake of heart transplantation using DCD donor hearts, which would otherwise be discarded. |
| تدمد: | 0973-7723 0970-9134 |
| DOI: | 10.1007/s12055-020-00998-x |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d238db009426946353e09814b72e7ac1 https://doi.org/10.1007/s12055-020-00998-x |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d238db009426946353e09814b72e7ac1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 09737723 09709134 |
|---|---|
| DOI: | 10.1007/s12055-020-00998-x |