Annals of cardiothoracic surgery最新文献

{"title":"Pediatric heart transplantation in donation after circulatory death: is it a feasible reality?-in time, yes!","authors":"Hosam F Ahmed, David L S Morales, Awais Ashfaq","doi":"10.21037/acs-2025-dcd-29","DOIUrl":"10.21037/acs-2025-dcd-29","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"14 1","pages":"64-66"},"PeriodicalIF":3.3,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical graft assessment of machine-perfused hearts donated after circulatory death.","authors":"Jorik H Amesz, Mark F A Bierhuizen, Sanne J J Langmuur, Dwight Dumay, Olivier C Manintveld, Yannick J H J Taverne, Natasja M S de Groot","doi":"10.21037/acs-2024-dcd-0019","DOIUrl":"10.21037/acs-2024-dcd-0019","url":null,"abstract":"<p><strong>Background: </strong>Normothermic ex situ heart perfusion (ESHP) has increased the donor pool with hearts donated after circulatory death (DCD), but functional assessment during ESHP using lactate trends is suboptimal. This study presents the clinical use of high-resolution cardiac mapping to assess electrical function of human DCD hearts on ESHP, where low-voltage-areas might be indicative of myocardial injury.</p><p><strong>Methods: </strong>Hearts were procured following circulatory arrest of the donor and restarted on normothermic ESHP. DCD hearts were transported to the recipient hospital and lactate concentrations were regularly measured in the perfusate. High-resolution epicardial mapping of the left (LV) and right ventricle (RV) was performed with a 192-electrode array during normothermic ESHP prior to transplantation. Unipolar potential voltages and slopes, conduction velocity and the amount of low-voltage potentials and conduction block were calculated from these recordings.</p><p><strong>Results: </strong>Electrical mapping was performed on ten DCD hearts transported on ESHP with sequential cardiac transplantation, showing safety and feasibility of the technique. Median potential voltage of the LV and RV was 15.7 mV (14.0-17.4 mV) and 11.3 mV (8.3-11.9 mV) respectively, and low-voltage potentials were minimally present. In comparison, the electrical function of one rejected heart with increasing lactate trend did not differ from the transplanted hearts.</p><p><strong>Conclusions: </strong>High-resolution electrical mapping of DCD hearts on ESHP may serve as novel additional diagnostic tool for assessing graft function, especially in marginal donors.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"495-501"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical techniques for cardiac allograft procurement and perfusion in controlled donation after circulatory death.","authors":"Antonio Loforte, Matteo Marro, Erika Simonato, Andrea Costamagna, Marco Ellena, Anna Chiara Trompeo, Marinella Zanierato, Luca Brazzi, Mauro Rinaldi, Massimo Boffini","doi":"10.21037/acs-2024-dcd-26","DOIUrl":"10.21037/acs-2024-dcd-26","url":null,"abstract":"<p><p>In the last decade, heart transplants using allografts from adult donors after circulatory death, in a controlled setting, controlled donation after circulatory death (cDCD) have been rapidly adopted and widely performed. The selection of retrieval methods has largely been determined by state or institutional guidelines concerning permissible postmortem procedures. A significant majority of cDCD heart recoveries have employed direct procurement and perfusion (DPP) followed by normothermic machine perfusion (NMP) for graft preservation. Another established method involves the thoracoabdominal normothermic regional perfusion (taNRP), which is then followed by either NMP or static cold storage. Processing, management and surgical techniques of heart allograft procurement after cDCD are herein described and discussed.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"522-530"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart transplantation from donation after circulatory death: a meta-analysis of national registries.","authors":"Vincenzo Tarzia, Matteo Ponzoni, Danila Azzolina, Luca Vedovelli, Nicola Pradegan, Dario Gregori, Gino Gerosa","doi":"10.21037/acs-2024-dcd-0077","DOIUrl":"10.21037/acs-2024-dcd-0077","url":null,"abstract":"<p><strong>Background: </strong>Although it has been widely recognized that heart transplantation (HT) following donation after circulatory death (DCD) can be a successful strategy to expand the donor pool, its clinical outcomes compared to donation after brain death (DBD) are still the subject of intense investigation. We reviewed the clinical characteristics of HT after DCD from the three largest multicenter nationwide registries, highlighting technical aspects, donor and recipient selection, and early outcomes. Moreover, we performed a meta-analysis of survival outcomes of DCD <i>vs.</i> DBD using reconstructed individual patient time-to-event data.</p><p><strong>Methods: </strong>The PubMed, Web of Science, and Scopus databases were searched in January 2024 to identify the most recent reports from three large multicenter nationwide registries (United States, United Kingdom, and Australia) of HT after DCD. Clinical characteristics were summarized using descriptive statistics, and survival curves were reconstructed for DBD using individual patient time-to-event data. The pooled hazard ratio (HR) with confidence interval (CI) was calculated via Cox regression.</p><p><strong>Results: </strong>A total of 646 DCD HT patients and 7,253 DBD controls were included in this review. In the majority of cases, donors were young males. The mean age of recipients ranged from 48 to 57 years, and the majority were males with idiopathic dilated cardiomyopathy. Up to 40% of patients required postoperative mechanical circulatory support with extracorporeal membrane oxygenation (ECMO). The meta-analysis estimated a pooled 1-year survival of 91.1% (95% CI: 88.6-93.7%) and 90.1% (95% CI: 89.4-90.8%) for DCD and DBD patients, respectively (P=0.91), with a pooled HR of 0.88 (95% CI: 0.65-1.20).</p><p><strong>Conclusions: </strong>Although the generally more favorable clinical profile of DCD donors and recipients may constitute a potential selection bias, our meta-analysis documented similar early and medium-term survival outcomes for DCD and DBD HT.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"464-473"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The thoracic surgeon perspective-lung transplantation in controlled donation after circulatory determination of death: any conflict with the heart?","authors":"Dirk Van Raemdonck, Janne Brouckaert, Jan Van Slambrouck, Katrien Vandendriessche, Laurens J Ceulemans, Filip Rega","doi":"10.21037/acs-2024-dcd-0032","DOIUrl":"10.21037/acs-2024-dcd-0032","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"516-518"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart and multiple organ transplantation from donation after circulatory death using mobile normothermic regional perfusion and cardiac surgery extra-corporeal membrane oxygenation team out of the hub transplant centre.","authors":"Sofia Martin-Suarez, Luca Botta, Giuseppe Barberio, Filippo Londi, Costanza Fiaschini, Davide Pacini","doi":"10.21037/acs-2024-dcd-22","DOIUrl":"10.21037/acs-2024-dcd-22","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"534-536"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiac surgeon perspective-cardiac transplantation following donation after circulatory death: expanding the donor pool.","authors":"Erin M Schumer, Mark S Slaughter","doi":"10.21037/acs-2024-dcd-0065","DOIUrl":"10.21037/acs-2024-dcd-0065","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"513-515"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart transplantation following donation after euthanasia.","authors":"Vincent Tchana-Sato, Gregory Hans, Janne Brouckaert, Olivier Detry, Oceane Jaquet, Mai-Linh Nguyen Trung, Arnaud Ancion, Katrien Vandendriessche, Johan Van Cleemput, Marc Gilbert Lagny, Filip Rega, Didier Ledoux","doi":"10.21037/acs-2024-dcd-0030","DOIUrl":"10.21037/acs-2024-dcd-0030","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"519-521"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoraco-abdominal normothermic regional perfusion in donation after circulatory death heart transplantation: a bridge from DCD to \"DBD-like\" donation.","authors":"Massimo Boffini, Matteo Marro, Erika Simonato, Marinella Zanierato, Antonio Loforte, Mauro Rinaldi","doi":"10.21037/acs-2024-dcd-23","DOIUrl":"10.21037/acs-2024-dcd-23","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"531-533"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult cardiac transplantation utilizing donors after circulatory death.","authors":"Tanisha Rajah, David Blitzer, Scott Silvestry, Hannah Copeland","doi":"10.21037/acs-2024-dcd-0069","DOIUrl":"10.21037/acs-2024-dcd-0069","url":null,"abstract":"<p><p>Donation after circulatory death (DCD) presents both opportunities and challenges in the realm of heart transplantation. Its emergence holds promise for narrowing the gap between patients in need of organs and the available donor pool. The rapid emergence of DCD use has allowed heart transplant volume to increase worldwide. Long-term outcomes and best practices remain to be defined and are important considerations in the wider use of these techniques in a broad selection of patients to understand best use and practice moving forward. Expanding DCD donation entails substantial resource allocation, coordination efforts, and training initiatives. Moving forward, standardization is imperative, particularly in aspects such as \"stand-off\" time, warm ischemic time (WIT), and perfusate composition.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"474-486"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}