Williams Aaron M, Ahmad Awab, Bommareddi Swaroop, Lima Brian, Nguyen Duc, Quintana Eric, Wang Chen Chia, Petrovic Mark, Siddiqi Hasan K, Amancherla Kaushik, Rali Aniket S, DeVries Stephen A, Keck Clifton D, Scholl Shelley R, Lepore Anthony J, Warhoover Matthew, Schlendorf Kelly H, Shah Ashish S, Pasrija Chetan, Trahanas John M
Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn.
Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn.
J Thorac Cardiovasc Surg. 2025 Aug;170(2):585-593.e2. doi: 10.1016/j.jtcvs.2025.02.023. Epub 2025 May 4.
We sought to provide a single-center analysis of our normothermic regional perfusion (NRP)-recovered donation after circulatory death (DCD) heart transplant outcomes compared with a historical control group of donors of donation after brain death (DBD). We hypothesized that postoperative short-term outcomes and long-term survival trends are comparable in DCD-NRP and DBD cardiac allografts.
All adult heart-only transplants performed at our institution between January 2020 and June 2024 were retrospectively reviewed. Recipients were stratified into 2 groups: DCD-NRP and DBD. Propensity score matching was used to compare postoperative short and long-term outcomes. Kaplan-Meier was used to evaluate survival.
Four hundred fifteen recipients met the inclusion criteria: 275 (63%) in the DBD group and 140 (37%) in the DCD-NRP group. In the propensity score-matching model there were no differences in severe primary graft dysfunction, mechanical circulatory support, right heart dysfunction, vasoactive inotropic scores, and 30-day mortality. There was also no difference in 1- and 3-year survival between groups.
In our single-center study, we found no differences in short and long-term outcomes between cardiac allografts from NRP-DCD compared with DBD donors. As such, NRP-recovered donors may be considered equivalent in terms of recipient outcomes to DBD donors.
我们试图对我们的常温区域灌注（NRP）恢复的心脏移植结果进行单中心分析，这些心脏移植来自循环死亡后捐赠（DCD）的供体，并与脑死亡后捐赠（DBD）的供体历史对照组进行比较。我们假设DCD-NRP和DBD心脏移植的术后短期结果和长期生存趋势具有可比性。
回顾性分析2020年1月至2024年6月在我们机构进行的所有仅成人心脏移植。接受者被分为两组：DCD-NRP组和DBD组。使用倾向评分匹配来比较术后短期和长期结果。使用Kaplan-Meier法评估生存率。
415名接受者符合纳入标准：DBD组275名（63%），DCD-NRP组140名（37%）。在倾向评分匹配模型中，严重原发性移植物功能障碍、机械循环支持、右心功能障碍、血管活性药物评分和30天死亡率方面没有差异。两组之间1年和3年生存率也没有差异。
在我们的单中心研究中，我们发现与DBD供体相比，NRP-DCD心脏移植的短期和长期结果没有差异。因此，就接受者结果而言，NRP恢复的供体可能被认为与DBD供体相当。
