Outcomes of Multiorgan Heart Transplant Between Donation After Circulatory Death and Brain Death.

IF 3.1 3区医学 Q2 ENGINEERING, BIOMEDICAL ASAIO Journal Pub Date : 2024-10-15 DOI:10.1097/MAT.0000000000002329

Toyokazu Endo, Jaimin R Trivedi, Stephanie Moore, Sheng Fu, Rohan Samson, Michele Gallo, Siddharth Pahwa, Mark S Slaughter, Erin M Schumer

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Abstract

There is insufficient data on the outcomes of donation after circulatory death (DCD) multiorgan transplant that includes heart. The primary objective of this study is to compare the overall survival outcomes of DCD and donation after brain death (DBD) multiorgan transplants. We identified all heart transplant patients from 2019 to June of 2023 using the United Network for Organ Sharing (UNOS) Database who also received an additional organ (kidney, liver, and lungs). A total of 1,844 DBD and 91 DCD multiorgan transplants occurred within the study period, the majority being combined heart-kidney transplantation. More patients were listed at a higher status in the DBD group (p < 0.05) and were in the intensive care unit (ICU) before transplant (p < 0.05). Despite the higher ischemia time in the DCD group (p < 0.05), the overall unmatched survival did not differ between the two groups (p < 0.05). Within the heart-kidney transplants, the overall survival between DBD and DCD heart-kidney transplants did not differ in either unmatched or matched groups (unmatched p = 0.5, matched p = 0.5). In conclusion, the data on the outcomes of DCD multiorgan transplants are limited. Still, our analysis of the currently available data suggests that the overall survival is comparable in the DCD multiorgan transplants.

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循环死亡和脑死亡后捐献多器官心脏移植的结果。

关于循环死亡（DCD）后捐献多器官移植（包括心脏）的结果，目前还没有足够的数据。本研究的主要目的是比较DCD和脑死亡后捐献（DBD）多器官移植的总体生存结果。我们利用器官共享联合网络（UNOS）数据库确定了2019年至2023年6月期间所有接受了额外器官（肾脏、肝脏和肺）移植的心脏移植患者。在研究期间，共进行了 1844 例 DBD 和 91 例 DCD 多器官移植，其中大多数是心脏-肾脏联合移植。DBD组中有更多的患者处于较高的状态（P＜0.05），并且在移植前已进入重症监护室（ICU）（P＜0.05）。尽管DCD组的缺血时间较长（P < 0.05），但两组的总体未配型存活率并无差异（P < 0.05）。在心肾移植中，DBD 和 DCD 心肾移植的总存活率在未配对组和配对组中均无差异（未配对 p = 0.5，配对 p = 0.5）。总之，DCD 多器官移植的结果数据有限。不过，我们对现有数据的分析表明，DCD 多器官移植的总生存率相当。

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来源期刊

ASAIO Journal 医学-工程：生物医学

CiteScore

6.60

自引率

7.10%

发文量

651

审稿时长

4-8 weeks

期刊介绍： ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.