Transplant Unit, Royal Papworth Hospital, Cambridge, UK.
Eur J Cardiothorac Surg. 2022 Jul 11;62(2). doi: 10.1093/ejcts/ezac083.
Transplantation of donation after circulatory death (DCD) donor hearts is gaining acceptance. However, DCD heart selection has been understandably cautious. We report a case of reconditioning a DCD heart using thoraco-abdominal normothermic regional perfusion in a 46-year-old donor who suffered irreversible brain injury following emergency type-A aortic dissection repair. The DCD heart was procured with cold preservation and directly transplanted into a 63-year-old male who was bridged to transplant with extracorporeal life support. The recipient required a brief period of mechanical circulatory support post-transplant but made a good recovery. To our knowledge, this is the first report of successful heart transplantation from such an extended criteria DCD donor.
心脏移植使用心跳停止后捐献(DCD)供体心脏的方式正在逐渐被接受。然而，对于 DCD 供体心脏的选择一直是比较谨慎的。我们报告了一个使用胸腹部常温区域灌注对一个 46 岁的供体进行再处理的案例，该供体在接受急症 A 型主动脉夹层修复后发生了不可逆转的脑损伤。使用低温保存的方式获取 DCD 供心，并直接移植到一名 63 岁的男性患者身上，该患者使用体外生命支持桥接移植。移植后，受者需要短暂的机械循环支持，但恢复良好。据我们所知，这是首例从如此延长标准的 DCD 供体成功进行心脏移植的报告。
