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Introduction of ex vivo perfusion of extended-criteria donor hearts in a single center in Asia.
Lee, Oswald Joseph On Jing; Bhatia, Inderjeet; Wan, Sylvia Ho Yan; Fan, Katherine Yue Yan; Wong, Michael Ka Lam; Au, Timmy Wing Kuk; Ho, Cally Ka Lai.
Afiliación
  • Lee OJOJ; Department of Cardiothoracic Surgery, New Clinical Building, Room 308, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, Hong Kong, China. ibhatiahk@gmail.com.
  • Bhatia I; Department of Cardiothoracic Surgery, New Clinical Building, Room 308, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, Hong Kong, China. bi546@ha.org.hk.
  • Wan SHY; Department of Cardiothoracic Surgery, New Clinical Building, Room 308, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, Hong Kong, China.
  • Fan KYY; Cardiac Medicine Unit, 5/F Kwok Tak Seng Heart Center, Grantham Hospital, Wong Chuk Hang, Hong Kong SAR, Hong Kong, China.
  • Wong MKL; Cardiac Medicine Unit, 5/F Kwok Tak Seng Heart Center, Grantham Hospital, Wong Chuk Hang, Hong Kong SAR, Hong Kong, China.
  • Au TWK; Department of Cardiothoracic Surgery, New Clinical Building, Room 308, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, Hong Kong, China.
  • Ho CKL; Department of Cardiothoracic Surgery, New Clinical Building, Room 308, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, Hong Kong, China.
J Artif Organs ; 2024 May 23.
Article en En | MEDLINE | ID: mdl-38780672
ABSTRACT
The shortage of organs for heart transplantation has created a need to explore the use of extended-criteria organs. We report the preliminary use of normothermic TransMedics Organ Care System-an ex vivo approach to preserve extended-criteria brain-dead donor hearts. This System maintains a normal temperature, provides continuous perfusion and oxygenation, reduces ischemic time, and enables additional viability assessment options. In a retrospective single-centre study conducted from April 2020 to March 2023, four extended criteria brain-dead donor hearts were perfused and monitored using the Organ Care System. Suitability for transplantation was assessed based on stable or decreasing lactate levels, along with appropriate perfusion parameters. The Organ Care for use of the Organ Care System were coronary artery disease, left ventricular hypertrophy, high-dose inotrope use in the donor, a downtime exceeding 20 min, and a left ventricular ejection fraction of 40-50%. Three out of the four donor hearts were transplanted, while one was discarded due to rising lactate concentration. The three recipients had a higher surgical risk profile for heart transplant. All showed normal cardiac function and no primary graft dysfunction postoperatively. At 2-3 years post-transplant, all recipients have a ventricular function of > 60%, with only one showing evidence of mild rejection. The Organ Care System enables the successful transplantation of marginal donor organs in high-risk recipients, showcasing the feasibility of recruiting donors with extended criteria. This technique is safe and promising, expanding the donor pool and addressing the organ shortage in heart transplantation in Hong Kong.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Artif Organs Asunto de la revista: ENGENHARIA BIOMEDICA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Japón
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Artif Organs Asunto de la revista: ENGENHARIA BIOMEDICA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Japón