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Adult heart transplantation with distant procurement and ex-vivo preservation of donor hearts after circulatory death: a case series

Dhital, Kumud K, Iyer, Arjun, Connellan, Mark, Chew, Hong C, Gao, Ling, Doyle, Aoife, Hicks, Mark, Kumarasinghe, Gayathri, Soto, Claude, Dinale, Andrew, Cartwright, Bruce, Nair, Priya, Granger, Emily, Jansz, Paul, Jabbour, Andrew, Kotlyar, Eugene, Keogh, Anne, Hayward, Christopher, Graham, Robert, Spratt, Phillip, Macdonald, Peter·2015·The Lancet
DOI 10.1016/s0140-6736(15)60038-1
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Abstract

Background Orthotopic heart transplantation is the gold-standard long-term treatment for medically refractive end-stage heart failure. However, suitable cardiac donors are scarce. Although donation after circulatory death has been used for kidney, liver, and lung transplantation, it is not used for heart transplantation. We report a case series of heart transplantations from donors after circulatory death. Methods The recipients were patients at St Vincent's Hospital, Sydney, Australia. They received Maastricht category III controlled hearts donated after circulatory death from people younger than 40 years and with a maximum warm ischaemic time of 30 min. We retrieved four hearts through initial myocardial protection with supplemented cardioplegia and transferred to an Organ Care System (Transmedics) for preservation, resuscitation, and transportation to the recipient hospital. Findings Three recipients (two men, one woman; mean age 52 years) with low transpulmonary gradients ( Interpretation Strict limitations on donor eligibility, optimised myocardial protection, and use of a portable ex-vivo organ perfusion platform can enable successful, distantly procured orthotopic transplantation of hearts donated after circulatory death. Funding NHMRC, John T Reid Charitable Trust, EVOS Trust Fund, Harry Windsor Trust Fund.

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Metadata

Authors
Dhital, K. K., Iyer, A., Connellan, M., Chew, H. C., Gao, L., Doyle, A., Hicks, M., Kumarasinghe, G., Soto, C., Dinale, A., Cartwright, B., Nair, P., Granger, E., Jansz, P., Jabbour, A., Kotlyar, E., Keogh, A., Hayward, C., Graham, R., Spratt, P., & Macdonald, P.
Venue
The Lancet
Publisher
Elsevier BV
Published
2015-06
Volume
385
Issue
9987
Pages
2585-2591
ISSN
0140-6736
DOI
10.1016/s0140-6736(15)60038-1
Cited by
436
References
0
Language
en
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)

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