Roest S, Kaffka Genaamd Dengler S E, van Suylen V, van der Kaaij N P, Damman K, van Laake L W, Bekkers J A, Dalinghaus M, Erasmus M E, Manintveld O C
Department of Cardiology, Thorax Centre, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
Neth Heart J. 2021 Feb;29(2):88-97. doi: 10.1007/s12471-020-01505-y. Epub 2020 Nov 6.
With more patients qualifying for heart transplantation (HT) and fewer hearts being transplanted, it is vital to look for other options. To date, only organs from brain-dead donors have been used for HT in the Netherlands. We investigated waiting list mortality in all Dutch HT centres and the potential of donation after circulatory death (DCD) HT in the Netherlands.
Two different cohorts were evaluated. One cohort was defined as patients who were newly listed or were already on the waiting list for HT between January 2013 and December 2017. Follow-up continued until September 2018 and waiting list mortality was calculated. A second cohort of all DCD donors in the Netherlands (lung, liver, kidney and pancreas) between January 2013 and December 2017 was used to calculate the potential of DCD HT.
Out of 395 patients on the waiting list for HT, 196 (50%) received transplants after a median waiting time of 2.6 years. In total, 15% died while on the waiting list before a suitable donor heart became available. We identified 1006 DCD donors. After applying exclusion criteria and an age limit of 50 years, 122 potential heart donors remained. This number increased to 220 when the age limit was extended to 57 years.
Waiting list mortality in the Netherlands is high. HT using organs from DCD donors has great potential in the Netherlands and could lead to a reduction in waiting list mortality. Cardiac screening will eventually determine the true potential.
随着符合心脏移植（HT）条件的患者增多而可供移植的心脏减少，寻找其他选择至关重要。迄今为止，荷兰仅使用脑死亡供体的器官进行心脏移植。我们调查了荷兰所有心脏移植中心的等待名单死亡率以及荷兰循环死亡后器官捐献（DCD）心脏移植的潜力。
评估了两个不同的队列。一个队列定义为2013年1月至2017年12月期间新列入或已在心脏移植等待名单上的患者。随访持续至2018年9月，并计算等待名单死亡率。第二个队列是2013年1月至2017年12月期间荷兰所有DCD供体（肺、肝、肾和胰腺），用于计算DCD心脏移植的潜力。
在395名心脏移植等待名单上的患者中，196名（50%）在中位等待时间2.6年后接受了移植。总共有15%的患者在等待合适的供体心脏期间死亡。我们确定了1006名DCD供体。应用排除标准和50岁的年龄限制后，仍有122名潜在心脏供体。当年龄限制延长至57岁时，这一数字增至220名。
荷兰等待名单死亡率很高。在荷兰，使用DCD供体器官进行心脏移植具有很大潜力，可能会降低等待名单死亡率。心脏筛查最终将确定其真正潜力。
