Early Single Center Experience with an Ex Vivo Organ Care System in Pediatric Heart Transplantation.

IF 6.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Heart and Lung Transplantation Pub Date : 2024-11-01 DOI:10.1016/j.healun.2024.10.027

Cathlyn K Medina, Berk Aykut, Lauren E Parker, Neel K Prabhu, Lillian Kang, Ziv Beckerman, Jacob N Schroder, Douglas M Overbey, Joseph W Turek

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Abstract

Pediatric heart transplantation (HTx) faces challenges such as limited donor availability and the need for complex reconstructions, particularly in patients with congenital anomalies. Ex vivo perfusion offers a promising approach to minimize graft ischemic time and potentially expand the donor pool. We report our single-center experience using the TransMedics Organ Care System (OCS) for ex vivo perfusion in pediatric HTx. From 2020-2024, eight pediatric patients received OCS-perfused donor hearts. Median recipient age was 13 years (range 9-18), and median weight was 58.8 kg (33.2-127.8). Indications for HTx included dilated cardiomyopathy (n=4), hypertrophic cardiomyopathy (n=1), graft vasculopathy (n=1), and Fontan failure (n=2). Median OCS time was 273 minutes (195-328), and recipient ischemic time was 85 minutes (64-139). Post-transplant, all patients had normal LV function at discharge. Over a median follow-up of 11.9 months, there were no deaths. These findings suggest that ex vivo perfusion is a valuable technique in pediatric HTx.

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在小儿心脏移植手术中使用体内器官护理系统的早期单中心经验。

小儿心脏移植（HTx）面临着供体有限和需要复杂重建等挑战，尤其是先天性畸形患者。体外灌注是一种很有前景的方法，它能最大限度地缩短移植物缺血时间，并有可能扩大供体库。我们报告了单中心使用 TransMedics 器官护理系统（OCS）进行体外灌注治疗小儿 HTx 的经验。2020-2024 年间，八名儿科患者接受了经 OCS 灌注的供体心脏。受体年龄中位数为13岁（9-18岁不等），体重中位数为58.8千克（33.2-127.8千克）。HTx的适应症包括扩张型心肌病（4例）、肥厚型心肌病（1例）、移植物血管病（1例）和Fontan衰竭（2例）。OCS时间中位数为273分钟（195-328），受体缺血时间为85分钟（64-139）。移植后，所有患者出院时左心室功能正常。中位随访时间为 11.9 个月，无死亡病例。这些研究结果表明，体外灌注是一种有价值的小儿热移植技术。

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来源期刊

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.