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Survival, function, and immune profiling after beating heart transplantation.
Krishnan, Aravind; Elde, Stefan; Ruaengsri, Chawannuch; Guenthart, Brandon A; Zhu, Yuanjia; Fawad, Moeed; Lee, Anson; Currie, Maria; Ma, Michael R; Hiesinger, William; Shudo, Yasuhiro; MacArthur, John Ward; Woo, Y Joseph.
Afiliación
  • Krishnan A; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Elde S; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Ruaengsri C; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Guenthart BA; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Zhu Y; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Fawad M; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Lee A; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Currie M; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Ma MR; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Hiesinger W; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Shudo Y; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • MacArthur JW; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
  • Woo YJ; Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif; Department of Bioengineering, Stanford University School of Engineering, Stanford, Calif. Electronic address: joswoo@stanford.edu.
J Thorac Cardiovasc Surg ; 2024 Aug 05.
Article en En | MEDLINE | ID: mdl-39111693
ABSTRACT

OBJECTIVE:

Ex vivo normothermic perfusion of cardiac allografts has expanded the donor pool for heart transplant. Using a beating heart implantation method avoids the second cardioplegic arrest and subsequent ischemia-reperfusion injury typically associated with ex vivo heart perfusion. We sought to describe our institutional experience with beating heart transplantation.

METHODS:

This was a single-institution retrospective study of adult patients who underwent heart transplantation using ex vivo heart perfusion (EVHP) and a beating heart implantation technique between October 2022 and March 2024. Primary outcomes of interest included survival, initiation of mechanical circulatory support, and rejection. A subanalysis of our institutional series of nonbeating deceased after circulatory death (DCD) heart transplantations was performed as well.

RESULTS:

Twenty-four patients underwent isolated heart transplantation with the use of ex vivo heart perfusion and beating heart implantation between October 2022 and March 2024; 21 (87.5%) received hearts from DCD donors, and 3 (12.5%) received hearts from deceased after brain death (DBD) donors. The median duration of follow-up was 192 days (interquartile range [IQR], 124-253.5 days), and 23 out of 24 patients (95.8%) were alive at last follow-up. No patients required initiation of mechanical circulatory support. The majority of patients had pathologic grade 0 rejection at the time of biopsy (n = 16; 66.7%), and the median cell-free DNA percent was 0.04% (IQR, 0.04%-0.09%). The rate of mechanical circulatory support initiation in the 22-patient nonbeating DCD heart transplant cohort was significantly higher, at 36.4% (P < .005).

CONCLUSIONS:

A beating heart implantation technique can be used for transplantation of DCD and DBD hearts on EVHP and is associated with excellent survival and low levels of rejection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
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 Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos