Chew, Hong Chee and Iyer, Arjun and Connellan, Mark and Scheuer, Sarah and Villanueva, Jeanette and Gao, Ling and Hicks, Mark and Harkness, Michelle and Soto, Claudio and Dinale, Andrew and Nair, Priya and Watson, Alasdair and Granger, Emily and Jansz, Paul and Muthiah, Kavitha and Jabbour, Andrew and Kotlyar, Eugene and Keogh, Anne and Hayward, Chris and Graham, Robert and Spratt, Phillip and Macdonald, Peter and Dhital, Kumud (2019) Outcomes of Donation After Circulatory Death Heart Transplantation in Australia. Journal of the American College of Cardiology, 73 (12). pp.1447-1459. ISSN 07351097
Full text not available from this repository.Abstract
BACKGROUND:
Transplantation of hearts retrieved from donation after circulatory death (DCD) donors is an evolving clinical practice.
OBJECTIVES:
The purpose of this study is to provide an update on the authors' Australian clinical program and discuss lessons learned since performing the world's first series of distantly procured DCD heart transplants.
METHODS:
The authors report their experience of 23 DCD heart transplants from 45 DCD donor referrals since 2014. Donor details were collected using electronic donor records (Donate Life, Australia) and all recipient details were collected from clinical notes and electronic databases at St. Vincent's Hospital.
RESULTS:
Hearts were retrieved from 33 of 45 DCD donors. A total of 12 donors did not progress to circulatory arrest within the pre-specified timeframe. Eight hearts failed to meet viability criteria during normothermic machine perfusion, and 2 hearts were declined due to machine malfunction. A total of 23 hearts were transplanted between July 2014 and April 2018. All recipients had successful implantation, with mechanical circulatory support utilized in 9 cases. One case requiring extracorporeal membrane oxygenation subsequently died on the sixth post-operative day, representing a mortality of 4.4% over 4 years with a total follow-up period of 15,500 days for the entire cohort. All surviving recipients had normal cardiac function on echocardiogram and no evidence of acute rejection on discharge. All surviving patients remain in New York Heart Association functional class I with normal biventricular function.
CONCLUSIONS:
DCD heart transplant outcomes are excellent. Despite a higher requirement for mechanical circulatory support for delayed graft function, primarily in recipients with ventricular assist device support, overall survival and rejection episodes are comparable to outcomes from contemporary brain-dead donors.
Item Type: | Article |
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Subjects: | R Medicine > R Medicine (General) |
Depositing User: | Repository Administrator |
Date Deposited: | 08 Apr 2019 03:47 |
Last Modified: | 08 Apr 2019 03:47 |
URI: | https://eprints.victorchang.edu.au/id/eprint/822 |
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