Annals of cardiothoracic surgery最新文献

{"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":"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}

{"title":"Australian outcomes from heart transplantation in the machine perfusion era.","authors":"Yashutosh Joshi, Campbell MacLean, Sam Emmanuel, Katherine Wang, Claudio Soto, Jeanette Villanueva, Ling Gao, Aoife Doyle, Sanjay Dutta, Jianxin Wu, Nikunj Vaidhya, Emily Granger, Alasdair Watson, Mark Connellan, Arjun Iyer, Paul Jansz, Peter Macdonald","doi":"10.21037/acs-2024-dcd-0074","DOIUrl":"10.21037/acs-2024-dcd-0074","url":null,"abstract":"<p><strong>Background: </strong>In the current era of heart transplantation, machine perfusion strategies are emerging as potential additions to the armamentarium of a transplant unit. Donation after circulatory death (DCD) donor hearts assessed through normothermic machine perfusion (NMP) has helped expand the donor pool. Hypothermic machine perfusion (HMP) is emerging as an alternative strategy to traditional static cold storage (SCS) when a prolonged ischemic time is anticipated in brain dead (BD) donors, this is important in Australia where long distant procurement is vital. In this study we examine the outcomes in our unit where both forms of machine perfusion (NMP and HMP), as well as SCS is utilized for donor heart preservation, with a particular focus on severe primary graft dysfunction (sPGD) and mortality.</p><p><strong>Methods: </strong>The year 2021 represents the year when both forms of machine perfusion were available to our unit. Heart transplants in our unit from January 2021 to February 2024 were categorized into three groups for retrospective analysis: (I) DCD-NMP group (n=44); (II) BD-HMP group (n=38), and (III) BD-SCS group (n=78).</p><p><strong>Results: </strong>There were no significant differences in the mean donor and recipient ages between the three groups. Donor preservation time in the BD-HMP group was significantly longer than the donor ischemic time in the BD-SCS group, and organ care system (OCS) run time in the DCD-NMP group (361±89 <i>vs.</i> 208±47 and 249±49 min respectively, P<0.001). For DCD-NMP, BD-HMP and BD-SCS groups respectively: 30-day survival was: 100%, 97% and 100%; 1-year survival was: 94%, 90% and 94%; 2-year survival was: 90%, 90% and 89% (P=0.9). There was no significant difference in the incidence of sPGD between the three groups (DCD-NMP: 7%, BD-HMP: 5%, and BD-SCS: 5%, P=0.9).</p><p><strong>Conclusions: </strong>Machine perfusion strategies represent important additions to the modern transplant unit and can expand the donor pool. Results are encouraging with no differences in 2-year survival or incidence of sPGD across the preservation modalities: DCD-NMP, BD-HMP, and BD-SCS.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"502-512"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799214","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":"Developing a thoracoabdominal normothermic regional perfusion (TA-NRP) program for the recovery of organs for thoracic transplant: lessons from the United States experience.","authors":"Kyle S Bilodeau, Sarah Y Park, Elizabeth Bashian, Jason Zakko, Michael T Cain, Jessica Y Rove, T Brett Reece, Joseph C Cleveland, Jordan R H Hoffman","doi":"10.21037/acs-2024-dcd-0038","DOIUrl":"10.21037/acs-2024-dcd-0038","url":null,"abstract":"<p><strong>Background: </strong>Heart and lung transplantation remain efficacious treatments for patients with end-stage cardiopulmonary failure. However, donor shortages remain a challenge to both providers and patients. Thoracoabdominal normothermic regional perfusion (TA-NRP) has been increasingly adopted to decrease organ ischemia from circulatory death donors and therefore increase the number of organs available for transplantation. Despite initial success, data on program genesis and implementation are limited. The aim of this manuscript is to characterize essential human resources, lessons, and key considerations needed to improve TA-NRP dissemination and thus adoption.</p><p><strong>Methods: </strong>Single-center evaluation of a TA-NRP program was conducted using a retrospective cohort study design. All procurements performed using TA-NRP were included. Quantitative data were summarized. Descriptive elements of programmatic genesis, implementation, and experience were summarized using an inductive reasoning approach.</p><p><strong>Results: </strong>Thirty TA-NRP procurements were performed. The average time from incision to TA-NRP initiation was 7±2 minutes and total time on TA-NRP was 87±28 minutes. In simple regression analysis, the average total TA-NRP time was noted to increase by approximately 0.86 minutes per procurement [95% confidence interval (CI): -0.10, 1.82, P=0.08], while the average warm ischemia time was noted to decrease by approximately 0.03 minutes per procurement (95% CI: -0.13, 0.07, P=0.43). Key programmatic elements during planning and implementation were identification of key stakeholders, early communication, proactive navigation of ethical concerns, staffing and equipment needs, and development of TA-NRP algorithms for pre, intra- and post-donation phases of care.</p><p><strong>Conclusions: </strong>Development of a TA-NRP program is both feasible and easily implemented at institutions with pre-existing organ donation after circulatory death (DCD) procurement experience. Early identification of key stakeholders with frequent communication identified areas in need of expanded resources and addressed early ethical concerns, while local implementation efforts supported operationalization of existing infrastructure for TA-NRP procurements.</p>","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 6","pages":"487-494"},"PeriodicalIF":3.3,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799216","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 role of robotic coronary artery bypass grafting in the current practice of surgical myocardial revascularization.","authors":"Joeri Van Puyvelde, Massimo Baudo, Gianluca Torregrossa, Wouter Oosterlinck","doi":"10.21037/acs-2023-rcabg-0198","DOIUrl":"10.21037/acs-2023-rcabg-0198","url":null,"abstract":"","PeriodicalId":8067,"journal":{"name":"Annals of cardiothoracic surgery","volume":"13 5","pages":"439-441"},"PeriodicalIF":3.3,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456641","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}