Comparative Analysis of Heart Procurement Methods in Donors After Circulatory Death
Session Number
MEDH 27
Advisor(s)
Dr. William Fiske Parker
Discipline
Medical and Health Sciences
Start Date
17-4-2024 11:05 AM
End Date
17-4-2024 11:20 AM
Abstract
Since 2019, there has been a notable rise in yearly heart transplantation rates following circulatory death (DCD) in the United States. The primary procurement methods are direct procurement and perfusion (DPP) and normothermic regional perfusion (NRP). DPP relies on ex situ machine perfusion with cold crystalloid cardioplegia followed by normothermic blood reperfusion. NRP involves in situ reperfusion using an open cardiopulmonary bypass circuit while clamping the innominate artery to prevent brain perfusion. Despite ethical controversies surrounding NRP, its procurement rates have significantly increased. However, organ procurement organizations do not consistently report specified methods, complicating survival rate analysis. Through empirical methods differentiating agonal time variables, we observed transplant cases categorized by procurement method using data from the Scientific Registry of Transplant Recipients between January 1, 2019, and December 31, 2021. Among 318 DCD heart transplants, 216 (68%) were procured via DPP and 102 (32%) via NRP. These findings could inform future research analyzing post-transplant survival rates.
Comparative Analysis of Heart Procurement Methods in Donors After Circulatory Death
Since 2019, there has been a notable rise in yearly heart transplantation rates following circulatory death (DCD) in the United States. The primary procurement methods are direct procurement and perfusion (DPP) and normothermic regional perfusion (NRP). DPP relies on ex situ machine perfusion with cold crystalloid cardioplegia followed by normothermic blood reperfusion. NRP involves in situ reperfusion using an open cardiopulmonary bypass circuit while clamping the innominate artery to prevent brain perfusion. Despite ethical controversies surrounding NRP, its procurement rates have significantly increased. However, organ procurement organizations do not consistently report specified methods, complicating survival rate analysis. Through empirical methods differentiating agonal time variables, we observed transplant cases categorized by procurement method using data from the Scientific Registry of Transplant Recipients between January 1, 2019, and December 31, 2021. Among 318 DCD heart transplants, 216 (68%) were procured via DPP and 102 (32%) via NRP. These findings could inform future research analyzing post-transplant survival rates.