Heart transplantation is the definitive treatment for refractory, end-stage heart failure. The number of patients awaiting transplantation far exceeds available organs. In an effort to expand the donor pool, donation after circulatory death (DCD) heart transplantation has garnered renewed interest. Unlike donation after brain death, DCD donors do not meet the criteria for brain death and are dependent on life-sustaining therapies. Procurement can include a direct strategy or a normothermic regional perfusion, whereby there is restoration of perfusion to the organ before explantation. There are new developments in cold storage and ex vivo perfusion strategies. Since its inception, there has been a steady improvement in post-transplant outcomes, largely attributed to advancements in operative and procurement strategies. In this narrative review, the authors address the unique considerations of DCD heart transplantation, including withdrawal of care, the logistics of procuring and resuscitating organs, outcomes compared with standard donation after brain death, and ethical considerations.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/j.jvca.2024.03.045 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact on Survival of Heart and Heart-Lung Transplantation in Patients With Cyanotic and Noncyanotic Congenital Heart Diseases.
Transplant Proc
December 2024
Heart Failure and Transplantation Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Department of Cardiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Department of Medicine, Universidad de Valencia, Spain.
Background: A high percentage of patients with congenital heart diseases (CHD) reach adulthood and, over time, require heart transplantation (HTx) or combined heart-lung transplantation (HLTx). Among CHD, there are subgroups associated with a higher risk.
Methods: Retrospective analysis of HTx and HLTx in CHD patients.
Mechanical Circulatory Support for Right Ventricular Primary Graft Dysfunction After Heart Transplant: A Review.
Clin Transplant
January 2025
Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands.
Primary graft dysfunction (PGD) is the most common cause of early mortality following heart transplantation. Although PGD can affect both ventricles, isolated right ventricular dysfunction (RV-PGD) is observed in nearly half of PGD patients. RV-PGD requires specific medical management to support the preload, afterload, and function of the failing RV; however, the use of mechanical circulatory support of the RV (RV-MCS) might be required when optimal medical therapy is insufficient in preventing forward failure and retrograde venous congestion.
View Article and Find Full Text PDFLong-term remission of TP53-mutated therapy-related acute myeloid leukaemia following allogeneic stem cell transplantation in a heart transplant recipient: A case report and literature review.
Br J Haematol
December 2024
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA.
A novel technique for heart-thymus en bloc transplantation in nonhuman primates.
Sci Rep
December 2024
Center for Transplantation Sciences, Massachusetts General Hospital, Boston, MA, USA.
The thymus is a rich source of regulatory T cells and plays a role in self-tolerance. Therefore, transplantation of a vascularized donor thymus may facilitate the induction of tolerance in recipients of a cotransplanted heart allograft. To investigate this hypothesis, we developed a new technique to procure the heart and thymus en bloc from juvenile donors and transplant the composite allograft into thymectomized recipients.
View Article and Find Full Text PDFAlcohol-induced gut microbial reorganization and associated overproduction of phenylacetylglutamine promotes cardiovascular disease.
Nat Commun
December 2024
Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
The mechanism(s) underlying gut microbial metabolite (GMM) contribution towards alcohol-mediated cardiovascular disease (CVD) is unknown. Herein we observe elevation in circulating phenylacetylglutamine (PAGln), a known CVD-associated GMM, in individuals living with alcohol use disorder. In a male murine binge-on-chronic alcohol model, we confirm gut microbial reorganization, elevation in PAGln levels, and the presence of cardiovascular pathophysiology.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!