Overcoming the Boundaries of Heart Warm Ischemia in Donation After Circulatory Death: The Padua Case.


Journal

ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109

Informations de publication

Date de publication:
09 Feb 2024
Historique:
medline: 9 2 2024
pubmed: 9 2 2024
entrez: 9 2 2024
Statut: aheadofprint

Résumé

A 45 year old male obese patient with a previous history of repaired congenital heart disease developed worsening heart failure making heart transplantation listing mandatory. Unfortunately, due to his anthropometric measures, the search for a suitable brain-dead donor was unsuccessful. For this reason, he accepted to be enrolled in the controlled donation after circulatory death (cDCD) program. According to the Italian Law regulating death declaration after cardiac arrest (no-touch period of 20 minutes-one of the longest in the world), we faced a 34 minute cardiac asystole, after which the heart was recovered through a thoraco-abdominal normothermic regional perfusion excluding the epiaortic vessels. The heart was then preserved by means of cold static storage. Heart transplantation was performed successfully without any signs of primary graft failure. Postoperative endomyocardial biopsies were negative for acute cellular and antibody-mediated rejection. Furthermore, echocardiographic and cardiac magnetic resonance evaluation of the heart did not show any functional abnormalities. The patient was discharged on post-operative day (POD) #39 in good clinical conditions.

Identifiants

pubmed: 38334806
doi: 10.1097/MAT.0000000000002141
pii: 00002480-990000000-00402
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASAIO.

Déclaration de conflit d'intérêts

Disclosure: The authors have no conflicts of interest to report.

Références

Ministry of Health: https://www.gazzettaufficiale.it/eli/id/1994/01/08/094G0004/sg
Italian National Transplant Center: https://www.trapianti.salute.gov.it/imgs/C_17_cntPubblicazioni_544_allegato.pdf
Brann A, Jackson B, White R, et al.: (191) Impact of functional warm ischemic time on short term outcomes in donation after circulatory death heart transplantation. J Heart Lung Transplant 42: S94, 2023.
Pasrija C, DeBose-Scarlett A, Keck CD, et al.: (192) Prolonged warm ischemic time is safe for cardiac donation after circulatory death. J Heart Lung Transplant 42: S94–S95, 2023.
Jernryd V, Metzsch C, Andersson B, Nilsson J: The influence of ischemia and reperfusion time on outcome in heart transplantation. Clin Transplant 34: e13840, 2020.
Goldsmith KA, Demiris N, Gooi JH, et al.: Life-years gained by reducing donor heart ischemic times. Transplantation 87: 243–248, 2009.
Scheuer SE, Jansz PC, Macdonald PS: Heart transplantation following donation after circulatory death: Expanding the donor pool. J Heart Lung Transplant 40: 882–889, 2021.
Orsi L, Gristina GR: Palliative sedation: The position statement of the Italian National Committee for Bioethics. Minerva Anestesiol 83: 524–528, 2017.

Auteurs

Gino Gerosa (G)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Paolo Zanatta (P)

Department of Critical Care, Anesthesiology and Intensive Care Unit, Ca' Foncello Hospital, Treviso, Italy.

Annalisa Angelini (A)

Cardiovascular Pathology, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Marny Fedrigo (M)

Cardiovascular Pathology, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Roberto Bianco (R)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Demetrio Pittarello (D)

Cardiac Surgery Anesthesiology and Intensive Care Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Tea Lena (T)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Alessia Pepe (A)

Institute of Radiology, Department of Medicine, University of Padua, Padua, Italy; and.

Giuseppe Toscano (G)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Fabio Zanella (F)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Giuseppe Feltrin (G)

Regional Health Department, Regional Transplant Center, Veneto Region, Italy.

Nicola Pradegan (N)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Vincenzo Tarzia (V)

From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Padova, Italy.

Classifications MeSH