Rise of the Machines - Normothermic Regional Perfusion Use in Heart Transplantation in the United States.

Autor:	Gouchoe DA; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH; COPPER Lab, The Ohio State University, Columbus, OH., Satija D; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH., Cui EY; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH; COPPER Lab, The Ohio State University, Columbus, OH., Schroder JN; Department of Surgery, Division of Cardiac Surgery, Duke University Medical Center, Durham, NC., Milano CA; Department of Surgery, Division of Cardiac Surgery, Duke University Medical Center, Durham, NC., Bishawi M; Department of Surgery, Emory University, Atlanta, GA., Alvarez AV; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH., Choi K; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH., Henn MC; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH., Lampert BC; Department of Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH., Mokadam NA; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH., Whitson BA; Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH; COPPER Lab, The Ohio State University, Columbus, OH., Ganapathi AM; Los Robles Regional Medical Center, Thousand Oaks, CA. Electronic address: asvin.ganapathi@osumc.edu.
Jazyk:	angličtina
Zdroj:	The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI:	10.1016/j.jtcvs.2024.12.001
Abstrakt:	Objective: Recently, normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP) have allowed for heart transplantation following donation after circulatory death (DCD). This study aimed to characterize utilization and variation of NRP and DPP in the United States. Methods: Heart transplants from 12/1/19-3/31/24 were identified from the United Network for Organ Sharing Database. DPP and NRP procurements were classified based on previously published methods. The groups were compared, and survival was assessed using Kaplan-Meier methods. Geographic and center variability was categorized using encrypted data. Results: There were 595 NRP transplants and 625 DPP transplants. Distance traveled and out of body time were significantly less for the NRP group (p<0.01 for both). There were no significant differences in post-operative dialysis, stroke or 1-year survival between groups, however post-operative pacemaker placement was higher with NRP (p<0.05). From 2019 to 2024, 54/61 centers (88.5%) used NRP, 50/61 centers (82%) used DPP, and 43/61 centers (70.5%) used both procurement techniques, with NRP currently being the most popular DCD procurement technique. Geographically, recipients from regions 2, 5 and 8 used NRP with greatest frequency, while those in regions 1, 3 and 10 used DPP with greatest frequency. Conclusion: NRP use is rising within the United States, with tremendous growth since its inception a few years ago. Significant variation still exists regarding utilization of NRP and DPP and further determination of the impact of each procurement and preservation strategy on transplantation outcomes is necessary. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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