See the published version of this preprint at Journal of Cardiothoracic Surgery.
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Case report
Marina Pérez Redondo
Hospital Universitario Puerta de Hierro Majadahonda
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2889-4312
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Controlled donation after circulatory death (cDCD) has emerged as one of the main strategies for increasing the organ donor pool. Because of the ischemic injury that follows the withdrawal of life-sustaining therapies, hearts from cDCD donors have not been considered for transplantation until recently. The ex-situ perfusion of hearts directly procured from cDCD donors has been used to allow the continuous perfusion of the organ and the assessment of myocardial viability prior to transplantation. Based on our experience with abdominal normothermic regional perfusion in cDCD, we designed a protocol to recover and validate hearts from cDCD donors using thoraco-abdominal normothermic regional perfusion without the utilization of an ex-situ device.
Case presentation
We describe the first case of a cDCD heart transplant performed with this approach in Spain. The donor was a 43-year-old asthmatic female diagnosed with severe hypoxic encephalopathy. She was considered a potential cDCD donor and a suitable candidate for multiorgan procurement including the heart via thoraco-abdominal normothermic regional perfusion. The heart recipient was a 60-year-old male diagnosed with amyloid cardiomyopathy. Cold ischemia time was 55 minutes. The surgery was uneventful.
Conclusions
This case report, the first of its kind in Spain, supports the feasibility of evaluating and successfully transplanting cDCD hearts without the need for ex-situ perfusion based on the use of thoraco-abdominal normothermic regional perfusion opening the way for multiorgan donation in cDCD.
Keywords
Controlled donation after circulatory death, heart transplantation, normothermic regional perfusion, case report
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CURRENT STATUS: Published
View the published article at Journal of Cardiothoracic Surgery.
Version 2
Posted 22 Oct, 2020
No community comments so far
Editorial decision: Accept
On 31 Oct, 2020
Editor assigned
On 14 Oct, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 13 Oct, 2020
No comments provided
Editorial decision: Major revision
On 04 Oct, 2020
Review #1 received
Received 27 Sep, 2020
Review #2 received
Received 08 Sep, 2020
Reviewer #2 agreed
On 25 Aug, 2020
Reviewers invited
Invitations sent on 22 Aug, 2020
Reviewer #1 agreed
On 22 Aug, 2020
First submitted
On 20 Aug, 2020
Editor assigned
On 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Journal of Cardiothoracic Surgery.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case report
Marina Pérez Redondo
Hospital Universitario Puerta de Hierro Majadahonda
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2889-4312
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Journal of Cardiothoracic Surgery.
Version 2
Posted 22 Oct, 2020
No community comments so far
Editorial decision: Accept
On 31 Oct, 2020
Editor assigned
On 14 Oct, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 13 Oct, 2020
No comments provided
Editorial decision: Major revision
On 04 Oct, 2020
Review #1 received
Received 27 Sep, 2020
Review #2 received
Received 08 Sep, 2020
Reviewer #2 agreed
On 25 Aug, 2020
Reviewers invited
Invitations sent on 22 Aug, 2020
Reviewer #1 agreed
On 22 Aug, 2020
First submitted
On 20 Aug, 2020
Editor assigned
On 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Journal of Cardiothoracic Surgery.
Background
Controlled donation after circulatory death (cDCD) has emerged as one of the main strategies for increasing the organ donor pool. Because of the ischemic injury that follows the withdrawal of life-sustaining therapies, hearts from cDCD donors have not been considered for transplantation until recently. The ex-situ perfusion of hearts directly procured from cDCD donors has been used to allow the continuous perfusion of the organ and the assessment of myocardial viability prior to transplantation. Based on our experience with abdominal normothermic regional perfusion in cDCD, we designed a protocol to recover and validate hearts from cDCD donors using thoraco-abdominal normothermic regional perfusion without the utilization of an ex-situ device.
Case presentation
We describe the first case of a cDCD heart transplant performed with this approach in Spain. The donor was a 43-year-old asthmatic female diagnosed with severe hypoxic encephalopathy. She was considered a potential cDCD donor and a suitable candidate for multiorgan procurement including the heart via thoraco-abdominal normothermic regional perfusion. The heart recipient was a 60-year-old male diagnosed with amyloid cardiomyopathy. Cold ischemia time was 55 minutes. The surgery was uneventful.
Conclusions
This case report, the first of its kind in Spain, supports the feasibility of evaluating and successfully transplanting cDCD hearts without the need for ex-situ perfusion based on the use of thoraco-abdominal normothermic regional perfusion opening the way for multiorgan donation in cDCD.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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