Department of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
J Heart Lung Transplant. 2024 Jan;43(1):32-35. doi: 10.1016/j.healun.2023.08.012. Epub 2023 Aug 22.
In the US, the first pediatric donation after circulatory death (DCD) thoracic transplant was done in 2004; however, ethical controversy led to minimal utilization of these donors. The present study was performed to characterize the current state of pediatric DCD heart and lung transplantation (HTx, LTx). Children (<18 year old) who underwent HTx or LTx using DCD donors from June 2004 to June 2022 were identified in the United Network for Organ Sharing registry. A total of 14 DCD recipients were identified: 7 (50%) HTx and 7 (50%) LTx. Donor and recipient demographics are described in Table 1. One and 5-year post-transplant survival were as follows: HTx recipients (64% for each) and LTx recipients (86%, 55%). Although often discussed, the national experience with DCD donors for pediatric HTx and LTx remains limited and not being practiced consistently by any pediatric program. Given the critical organ shortage, DCD use in the field of pediatric thoracic transplantation should be strongly considered.
在美国，2004 年完成了首例儿科循环死亡后（DCD）供体的胸腔移植；然而，由于伦理争议，这些供体的利用率非常低。本研究旨在描述目前儿科 DCD 心脏和肺移植（HTx、LTx）的情况。在器官共享联合网络登记处，确定了 2004 年 6 月至 2022 年 6 月期间使用 DCD 供体进行 HTx 或 LTx 的儿童（<18 岁）。共有 14 名 DCD 受者：7 名（50%）HTx 和 7 名（50%）LTx。表 1 描述了供者和受者的人口统计学特征。移植后 1 年和 5 年的存活率如下：HTx 受者（各为 64%）和 LTx 受者（86%，55%）。尽管经常讨论，但美国儿科 HTx 和 LTx 中使用 DCD 供体的经验仍然有限，而且并非所有儿科项目都一致采用。鉴于器官严重短缺，应强烈考虑在儿科胸腔移植领域使用 DCD。
