Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
J Heart Lung Transplant. 2023 Aug;42(8):1040-1044. doi: 10.1016/j.healun.2023.04.009. Epub 2023 Apr 23.
Thoracoabdominal normothermic regional perfusion has emerged as an alternative method to procure donation after circulatory death (DCD) hearts, but its impact on concomitantly procured lung allografts remains unclear. The United Network for Organ Sharing database identified 627 DCD donors whose hearts were procured (211 in situ perfused, 416 directly procured) between December 2019 to December 2022. Lung utilization rates were 14.9% (63/422) for in situ perfused donors and 13.8% (115/832) for directly procured donors (p = 0.80). Following transplantation, lung recipients from in situ perfused donors required numerically lower rates of extracorporeal membrane oxygenation (7.7% vs 17.0%, p = 0.26) and mechanical ventilation (34.6% vs 47.2%, p = 0.29) at 72 hours. Six-month post-transplant survival was similar between groups (85.7% vs 89.1%, p = 0.67). These results suggest that the use of thoracoabdominal normothermic regional perfusion in DCD heart procurement may not adversely impact recipients of concomitantly procured lung allografts.
胸腹部常温区域灌注已成为获取心跳停止后供体（DCD）心脏的替代方法，但它对同时获取的肺移植物的影响尚不清楚。美国器官共享网络数据库确定了 627 名 DCD 供体，他们的心脏在 2019 年 12 月至 2022 年 12 月期间被采集（211 例原位灌注，416 例直接采集）。原位灌注供体的肺使用率为 14.9%（63/422），直接采集供体的肺使用率为 13.8%（115/832）（p=0.80）。移植后，原位灌注供体的肺受体在 72 小时时需要体外膜氧合（ECMO）的比例较低（7.7%比 17.0%，p=0.26）和机械通气（34.6%比 47.2%，p=0.29）。两组 6 个月的移植后存活率相似（85.7%比 89.1%，p=0.67）。这些结果表明，在 DCD 心脏采集过程中使用胸腹部常温区域灌注可能不会对同时采集的肺移植物受体产生不利影响。
