Kucera John A, Overbey Douglas M, Turek Joseph W
Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, NC.
Duke Children's Pediatric and Congenital Heart Center, Duke University, Durham, NC.
N Engl J Med. 2025 Jul 17;393(3):275-280. doi: 10.1056/NEJMoa2503487.
Cardiac allotransplantation is warranted in children with end-stage heart failure or irreparable congenital heart disease. A dearth of organs for transplantation has contributed to long wait-list times and resultant deaths in this population. Donation after circulatory death (DCD) with normothermic regional perfusion has the potential to increase the donor pool by up to 30%. Ethical concerns have limited adoption of this technique in the United States and abroad. Consequently, a method facilitating ex vivo resuscitation of hearts from deceased donors after circulatory death (i.e., DCD hearts) is needed. We describe an on-table reanimation of a pediatric DCD heart transplanted into a 3-month-old recipient. Adverse events are reported.
心脏同种异体移植适用于患有终末期心力衰竭或无法修复的先天性心脏病的儿童。可用于移植的器官短缺导致该人群在等待名单上的时间过长并最终死亡。采用常温局部灌注的循环死亡后器官捐献(DCD)有可能使供体库增加多达30%。伦理问题限制了该技术在美国和国外的应用。因此,需要一种促进对循环死亡后(即DCD心脏)已故供体心脏进行体外复苏的方法。我们描述了将一颗小儿DCD心脏移植到一名3个月大受者体内时在手术台上的复苏情况。报告了不良事件。