Machine Perfusion for Recovery of Brain Death Donor Hearts From Extended Distances.

IF 3.1 3区医学 Q2 ENGINEERING, BIOMEDICAL

ASAIO Journal Pub Date : 2025-03-01 Epub Date: 2024-12-19 DOI:10.1097/MAT.0000000000002315

Suguru Ohira, Sooyun Caroline Tavolacci, Kenji Okumura, Ameesh Isath, Vasiliki Gregory, Corazon de la Pena, Masashi Kai

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引用次数: 0

Abstract

The emerging ex vivo machine perfusion (MP) enables the extension of ex situ intervals, potentially expanding the heart transplant (OHT) donor pool. From October 18, 2018, to June 30, 2023, isolated OHT using donation after brain death (DBD) from extended distances (>500 miles) were identified in the United Network for Organ Sharing database, and categorized into cold storage (non-MP, N = 1,212) and MP group (N = 152). The MP utilization rate for DBD hearts from extended distances surged from 0% in 2018 to 27.7% in 2023. Recipient characteristics including listing status were similar except for history of cardiac surgery (non-MP, 32% vs. MP, 41%, p = 0.019). The travel distance was longer in MP group (696 vs. 894 miles, p < 0.001), as was donor organ preservation time (4.42 vs. 6.27 hours, p < 0.001). One-year survival was similar between groups (non-MP, 93.0 ± 0.8% vs. MP, 90.5 ± 2.9%, p = 0.23). In multivariable Cox hazards models, MP was not associated with mortality (hazard ratio, 1.19; p = 0.60). Among MP cohort, survival was comparable between hearts transported between 500-999 miles (N = 112) and those over 1,000 miles (N = 40). The utilization of MP for DBD heart recovery allows for safe DBD recovery from extended distance with comparable survival to cold storage.

查看原文本刊更多论文

远距离脑死亡捐献者心脏复苏的机器灌注。

新兴的离体机器灌注（MP）能够延长离体间隔，潜在地扩大心脏移植（OHT）供体池。从2018年10月18日至2023年6月30日，在美国器官共享网络数据库中确定了远距离（bbb500英里）使用脑死亡后捐赠（DBD）分离的OHT，并将其分为冷库（非MP， N = 1,212）和MP组（N = 152）。远距离DBD心脏的MP利用率从2018年的0%飙升至2023年的27.7%。除心脏手术史外，包括名单状态在内的受体特征相似（非MP， 32% vs MP, 41%, p = 0.019）。MP组行走距离更长（696比894英里，p < 0.001），供体器官保存时间更长（4.42比6.27小时，p < 0.001）。两组一年生存率相似（非MP， 93.0±0.8% vs MP, 90.5±2.9%,p = 0.23）。在多变量Cox风险模型中，MP与死亡率无关(风险比1.19；P = 0.60)。在MP队列中，心脏运输距离在500-999英里（N = 112）和超过1000英里（N = 40）之间的生存率是相当的。MP用于DBD心脏恢复，可以从延长的距离中安全恢复DBD，其存活率与冷藏相当。

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

ASAIO Journal 医学-工程：生物医学

CiteScore

6.60

自引率

7.10%

发文量

651

审稿时长

4-8 weeks

期刊介绍： ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.