The Rapidly Evolving Landscape of DCD Heart Transplantation.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2024-10-09 DOI:10.1007/s11886-024-02148-w

Yashutosh Joshi, Katherine Wang, Campbell MacLean, Jeanette Villanueva, Ling Gao, Alasdair Watson, Arjun Iyer, Mark Connellan, Emily Granger, Paul Jansz, Peter Macdonald

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引用次数: 0

Abstract

Purpose of review: To summarise current international clinical outcomes from donation after circulatory death heart transplantation (DCD-HT); discuss procurement strategies, their impact on outcomes and overall organ procurement; and identify novel approaches and future areas for research in DCD-HT.

Recent findings: Globally, DCD-HT survival outcomes (regardless of procurement strategy) are comparable to heart transplantation from brain dead donors (BDD). Experience with normothermic machine perfusion sees improvement in rates of primary graft dysfunction. Techniques have evolved to reduce cold ischaemic exposure to directly procured DCD hearts, though controlled periods of cold ischaemia can likely be tolerated. There is interest in hypothermic machine perfusion (HMP) for directly procured DCD hearts, with promising early results. Survival outcomes are firmly established to be equivalent between BDD and DCD-HT. Procurement strategy (direct procurement vs. regional perfusion) remains a source of debate. Methods to improve allograft warm ischaemic tolerance are of interest and will be key to the uptake of HMP for directly procured DCD hearts.

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快速发展的 DCD 心脏移植手术。

综述目的：总结目前国际上循环死亡后捐献心脏移植（DCD-HT）的临床结果；讨论获取策略、其对结果和整体器官获取的影响；确定DCD-HT的新方法和未来研究领域：在全球范围内，DCD-HT 的存活结果（无论采用何种采购策略）与脑死亡捐献者（BDD）的心脏移植结果相当。根据常温机器灌注的经验，初级移植物功能障碍的发生率有所改善。目前已发展出一些技术，以减少直接获取的 DCD 心脏的低温缺血暴露，但低温缺血的控制时间可能是可以忍受的。对直接获取的 DCD 心脏进行低温机器灌注 (HMP) 引起了人们的兴趣，并取得了令人鼓舞的早期结果。经证实，BDD 和 DCD-HT 的存活率相当。采购策略（直接采购与区域灌注）仍是争论的焦点。提高同种异体温暖缺血耐受性的方法值得关注，这将是直接采购的 DCD 心脏采用 HMP 的关键。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.