{"title":"循环死亡后的心脏移植捐赠:现状与影响。","authors":"Savitri Fedson","doi":"10.1097/HCO.0000000000001109","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>The use of cardiac transplantation following circulatory death (DCD) has been limited worldwide. Concerns about cardiac function after warm ischemia and the potential for decreased graft function have been important considerations in this hesitancy. In addition, ethical and legal questions about the two widely used organ procurement methods have led to discussions and public education in many countries.</p><p><strong>Recent findings: </strong>Publication of a US randomized trial of cardiac transplantation following DCD has shown that it is both feasible and has similar short-term outcomes compared with cardiac transplantation following brain death (DBD). These data support those from both Australia and the UK who have largest experience to date.</p><p><strong>Summary: </strong>The adoption of cardiac transplantation following circulatory death has increased overall cardiac transplantation in those transplant centers who have incorporated these donors. Short term outcomes for DCD organ procurement methods are similar to those outcomes using DBD hearts. Continued study and standardization of warm ischemic times will allow for better comparisons of organ procurement techniques and organ optimization. The ethical concerns about procurement methods, in addition to a discussion of procurement costs and feasibility will need to be addressed further in the efforts to expand the organ pool and increase overall cardiac transplantation numbers.</p>","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"128-134"},"PeriodicalIF":2.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Heart transplant donation after circulatory death: current status and implications.\",\"authors\":\"Savitri Fedson\",\"doi\":\"10.1097/HCO.0000000000001109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>The use of cardiac transplantation following circulatory death (DCD) has been limited worldwide. Concerns about cardiac function after warm ischemia and the potential for decreased graft function have been important considerations in this hesitancy. In addition, ethical and legal questions about the two widely used organ procurement methods have led to discussions and public education in many countries.</p><p><strong>Recent findings: </strong>Publication of a US randomized trial of cardiac transplantation following DCD has shown that it is both feasible and has similar short-term outcomes compared with cardiac transplantation following brain death (DBD). These data support those from both Australia and the UK who have largest experience to date.</p><p><strong>Summary: </strong>The adoption of cardiac transplantation following circulatory death has increased overall cardiac transplantation in those transplant centers who have incorporated these donors. Short term outcomes for DCD organ procurement methods are similar to those outcomes using DBD hearts. Continued study and standardization of warm ischemic times will allow for better comparisons of organ procurement techniques and organ optimization. The ethical concerns about procurement methods, in addition to a discussion of procurement costs and feasibility will need to be addressed further in the efforts to expand the organ pool and increase overall cardiac transplantation numbers.</p>\",\"PeriodicalId\":55197,\"journal\":{\"name\":\"Current Opinion in Cardiology\",\"volume\":\" \",\"pages\":\"128-134\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Opinion in Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/HCO.0000000000001109\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HCO.0000000000001109","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Heart transplant donation after circulatory death: current status and implications.
Purpose of review: The use of cardiac transplantation following circulatory death (DCD) has been limited worldwide. Concerns about cardiac function after warm ischemia and the potential for decreased graft function have been important considerations in this hesitancy. In addition, ethical and legal questions about the two widely used organ procurement methods have led to discussions and public education in many countries.
Recent findings: Publication of a US randomized trial of cardiac transplantation following DCD has shown that it is both feasible and has similar short-term outcomes compared with cardiac transplantation following brain death (DBD). These data support those from both Australia and the UK who have largest experience to date.
Summary: The adoption of cardiac transplantation following circulatory death has increased overall cardiac transplantation in those transplant centers who have incorporated these donors. Short term outcomes for DCD organ procurement methods are similar to those outcomes using DBD hearts. Continued study and standardization of warm ischemic times will allow for better comparisons of organ procurement techniques and organ optimization. The ethical concerns about procurement methods, in addition to a discussion of procurement costs and feasibility will need to be addressed further in the efforts to expand the organ pool and increase overall cardiac transplantation numbers.
期刊介绍:
Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.