Sathianathan Shyama, Bhat Geetha
School of Medicine, Penn State College of Medicine, 500 University Dr, Hershey, PA, 17033, USA.
Heart and Vascular Institute, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA.
Curr Cardiol Rep. 2022 Feb;24(2):119-130. doi: 10.1007/s11886-021-01631-y. Epub 2022 Feb 18.
The rate of heart transplants, while steadily increasing, is insufficient to meet the growing list of transplant candidates. Marginal donors expand the donor pool. However, criteria used to identify donors greatly vary by institution.
The International Society of Heart and Lung Transplant (ISHLT) heart transplant report of 2020 reinforced the importance of donor selection criteria on heart transplant outcomes. Existing literature challenges and reinforces the report's findings. Newer methods, such as donation after circulatory death (DCD), also recontextualize existing donor selection criteria. Transplant prediction models from international databases are poor predictors of individual centers' outcome. Further study is needed to understand associations among donor risk factors, and update the methods used for donor heart selection. In this review, we examine the current literature on extended donor criteria and recommend a model for donor selection.
心脏移植的数量虽然在稳步增加，但仍不足以满足不断增长的移植候选者名单。边缘供体扩大了供体库。然而，各机构用于识别供体的标准差异很大。
国际心肺移植学会（ISHLT）2020年的心脏移植报告强调了供体选择标准对心脏移植结果的重要性。现有文献对该报告的结果提出了挑战并加以强化。新的方法，如循环死亡后捐赠（DCD），也重新界定了现有的供体选择标准。来自国际数据库的移植预测模型并不能很好地预测各个中心的结果。需要进一步研究以了解供体风险因素之间的关联，并更新用于供体心脏选择的方法。在本综述中，我们研究了有关扩大供体标准的当前文献，并推荐了一种供体选择模型。
