Real World Experience with Transmedics Organ Care System in Cardiac Transplantation with Donor Organs Associated with Marginal Risk Factors
| Autor: | V. Sharma, B. Thomson, P. Raymond, George Javorsky, Yee Weng Wong, A. Prabhu, M. Davidson, J. Maddicks-Law |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Coronary angiography Transplantation medicine.medical_specialty Ejection fraction business.industry Cold storage Primary Graft Dysfunction Donor heart Internal medicine Circulatory system medicine Cardiology Surgery Cardiology and Cardiovascular Medicine Index hospitalization business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 40:S195-S196 |
| ISSN: | 1053-2498 |
| Popis: | Purpose Donor organ acceptance is limited by preservation method using cold storage. We sought to evaluate the efficacy of normothermic TransMedics OCS Heart to preserve BD donor organ associated with pre-donation criteria that may increase risk of primary graft dysfunction (expanded criteria). Methods All cardiac transplantations between 2017-19 were evaluated in this single-centre, observational analysis. Expanded criteria was defined as: (I) cold ischaemic time between 4-8 hours, (ii) donor age >55 year-old with normal coronary angiography, (iii) reported circulatory down-time > 20mins, (iv) LVEF Results Between July 2017 and December 2019, the OCS Heart Retrieval team was dispatched on 9 occasions, with 8 cases of ex-vivo organ retrievals. Of the 8 cases, 6 were successfully transplanted. With a total of 43 heart transplants were undertaken, availability of OCS Heart effectively allowed 14% increase in successful transplantation (6/43). Donor organ retrieval using TransMedics OCS Heart was associated with significant reduction in the total cold ischaemic time compared to cold storage (192.4mins vs 80.33mins, p=0.0005). Despite the expanded criteria, donor hearts that were successfully preserved were associated with comparable clinical outcomes: index hospitalization length of stay (P=0.97) and excellent post-transplant survival (Figure). Conclusion Normothermic donor heart preservation, with TransMedics OCS, allows comparatively safe transplantation with expanded criteria BD donor organ compared to conventional cold storage method with conservation donor characteristics. |
| Databáze: | OpenAIRE |
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