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应用体外供体器官灌流技术于标准风险供体行心脏移植的长期效果:单中心经验。

Long-term outcomes after heart transplantation using ex vivo allograft perfusion in standard risk donors: A single-center experience.

机构信息

Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.

出版信息

Clin Transplant. 2022 May;36(5):e14591. doi: 10.1111/ctr.14591. Epub 2022 Jan 23.

Abstract

INTRODUCTION

The Organ Care System (OCS) is an ex vivo perfusion platform for donor heart preservation. Short/mid-term post-transplant outcomes after its use are comparable to standard cold storage (CS). We evaluated long-term outcomes following its use.

METHODS

Between 2011 and 2013, 38 patients from a single center were randomized as a part of the PROCEED II trial to receive allografts preserved with CS (n = 19) or OCS (n = 19). Endpoints included 8-year survival, survival free from graft-related deaths, freedom from cardiac allograft vasculopathy (CAV), non-fatal major adverse cardiac events (NF-MACE), and rejections.

RESULTS

Eight-year survival was 57.9% in the OCS group and 73.7% in the CS group (p = .24). Freedom from CAV was 89.5% in the OCS group and 67.8% in the CS group (p = .13). Freedom from NF-MACE was 89.5% in the OCS group and 67.5% in the CS group (p = .14). Eight-year survival free from graft-related death was equivalent between the two groups (84.2% vs. 84.2%, p = .93). No differences in rejection episodes were observed (all p > .5).

CONCLUSIONS

In select patients receiving OCS preserved allografts, late post-transplant survival trended lower than those transplanted with an allograft preserved with CS. This is based on a small single-center series, and larger numbers are needed to confirm these findings.

摘要

简介

器官保存系统(OCS)是一种用于供体心脏保存的体外灌注平台。使用该系统后的短期/中期移植后结果与标准冷藏(CS)相当。我们评估了使用后的长期结果。

方法

在 2011 年至 2013 年期间,来自单个中心的 38 名患者作为 PROCEED II 试验的一部分被随机分为 CS(n=19)或 OCS(n=19)保存的同种异体移植物。终点包括 8 年生存率、无移植相关死亡的生存率、无心脏移植血管病(CAV)、非致命性主要不良心脏事件(NF-MACE)和排斥反应。

结果

OCS 组 8 年生存率为 57.9%,CS 组为 73.7%(p=0.24)。OCS 组无 CAV 发生率为 89.5%,CS 组为 67.8%(p=0.13)。OCS 组无 NF-MACE 发生率为 89.5%,CS 组为 67.5%(p=0.14)。两组 8 年无移植相关死亡生存率相当(84.2%比 84.2%,p=0.93)。未观察到排斥反应(均 p>0.5)。

结论

在接受 OCS 保存同种异体移植物的选定患者中,移植后晚期生存率趋势低于接受 CS 保存同种异体移植物的患者。这是基于一项小型单中心研究,需要更大的样本量来证实这些发现。

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