Evolution of heart transplantation since Barnard’s first

Javier, Mariano Francisco del Maria; Delmo, Eva Maria Javier; Hetzer, Roland

doi:10.21037/cdt-20-289

Cited by 13 publications

(12 citation statements)

References 52 publications

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“…This phenomenon is widely reported 13,14,17 . In our experience, most of them have been children due to the lack of donors and the slowly growing number of HTx in developing countries, coinciding with regional experiences 15,18 …”

Section: Discussionsupporting

confidence: 57%

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Heart transplantation at the Peruvian National Heart Institute: One‐decade single‐center experience

Pinto‐Salinas

Morón-Castro

Chavarri‐Velarde

et al. 2022

Journal of Cardiac Surgery

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Background Heart transplantations are ideal for most patients with end‐stage heart failure refractory to medical treatment. The transplantation program at the Peruvian National Heart Institute started with a 10‐year continuity in 2010. Objective To compare our 10‐year heart transplantation experience results with international standards and reflect on our Transplant Program. Methods We studied 83 patients who underwent orthotopic heart transplantation at a single center between January 2010 and December 2019. The recipients' profiles and survival rates were analyzed according to sex and age group, ensuring the information's confidentiality. Results The recipients' mean age was 41.2 ± 17 years, 88% were adults, and 68.7% were male. The main indications for transplantation were idiopathic dilated cardiomyopathy. 85.5% of recipients were clinically categorized as INTERMACS profiles 1–3 before transplantation. There was a significant difference between sexes regarding the preoperative left ventricular ejection fraction and between age groups regarding the waiting time. The average ischemia time was 3.1 h, operating time was 6.1 h, cardiopulmonary bypass time was 3 h, and aortic cross‐clamp time was 1.7 h. The principal early postoperative complications were hematological disorders and acute kidney failure. The principal late ones were kidney failure and severe anemia. The postoperative mortality was 15.9%, and the principal causes were infection and then acute rejection. The survival at 1, 5, and 10 years was 87.5%, 79.8%, and 79.8%, respectively. The survival results were not influenced by sex or age group. Conclusion Our patients' postoperative complications, mortality, and survival rates coincided with those reported by the ISHLT registry.

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Section: Discussionsupporting

confidence: 57%

“…13,14,17 In our experience, most of them have been children due to the lack of donors and the slowly growing number of HTx in developing countries, coinciding with regional experiences. 15,18 Like ISHLT reports, our main indications were idiopathic DCM in 66.3% of HTx and ischemic cardiomyopathy in 18.1%. 19 Although…”

Section: Discussionmentioning

confidence: 53%

Heart transplantation at the Peruvian National Heart Institute: One‐decade single‐center experience

Pinto‐Salinas

Morón-Castro

Chavarri‐Velarde

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

show abstract

“…This phenomenon is widely reported (15,16,18). In our experience, most of them have been children due to the lack of donors and the slowly growing number of HTx in developing countries, coinciding with regional experiences (17,20).…”

Section: Discussionsupporting

confidence: 52%

Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

Pinto‐Salinas

Morón-Castro

Chavarri‐Velarde

et al. 2021

Preprint

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Background: Heart transplantations are ideal for most patients with end-stage heart failure refractory to medical treatment. The transplantation program at the Peruvian National Heart Institute started with a 10-year-continuity in 2010. Objective: To report the results of a 10-year heart transplantation experience at the Peruvian National Heart Institute. Methods: We studied 83 patients who underwent orthotopic heart transplantation at a single center between January 2010 and December 2019. The recipients’ profiles and survival were analyzed according to sex and age group, ensuring the information’s confidentiality. Results: The recipients’ mean age was 41.2 ± 17 years, 88% were adult, and 68.7% were male. The main indications for transplantation were idiopathic dilated cardiomyopathy. 85.5% of recipients were clinically categorized as INTERMACS Profile 1 to 3 before transplantation. There was a significant difference between sexes regarding the preoperative left ventricular ejection fraction and between age groups regarding the waiting time. The average ischemia time was 3.1 hours, operating time was 6.1 hours, cardiopulmonary bypass time was 3 hours, and aortic cross-clamp time was 1.7 hours. The principal early postoperative complications were hematological disorders and acute kidney failure. The principal late ones were kidney failure and severe anemia. The postoperative mortality was 15.9%, and the principal causes were infection and then acute rejection. The survival at one, five, and ten years was 87.5%, 79.8%, and 79.8%, respectively. The survival results were not influenced by sex or age group. Conclusion: Our patients’ postoperative complications, mortality, and survival rates coincided with those reported by the ISHLT registry.

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“…Although the recipient ultimately succumbed to pneumonia and acute rejection after 18 days, the foundation had been laid for future heart transplants to follow [ 11 ]. Subsequent to this, the number of heart transplantations began to increase globally, aided in particular by the 1968 Harvard Medical School Committee statement defining brain death [ 12 ].…”

Section: The Long Journey Of Dcd Donor Heartsmentioning

confidence: 99%

Donation After Circulatory Death: A New Frontier

et al. 2022

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Purpose of Review To highlight the current global experience with DCD heart transplantation and explore the evolution of, and compare preservation strategies; examine early clinical outcomes, and discuss the growing use of DCD donors as a new frontier in heart transplantation. Recent Findings The two strategies of DCD heart preservation include NMP using the OCS Heart and TA-NRP followed by either: NMP or CSS. Better understanding the limits of cold ischaemia following TA-NRP will aid in distant procurement. Asystolic warm ischaemia plays an important role in determining immediate post-operative graft function and potential need for mechanical support. Large volume DCD heart transplant units show no difference in survival between DCD and DBD donor heart transplants. Summary In a previously non-utilised source of donor hearts, often viewed as an “unknown frontier” in heart transplantation, DCD hearts are a suitable alternative to brain-dead donor hearts and are likely to remain a permanent part of the heart transplantation landscape. Global uptake is currently increasing, and as understanding of preservation strategies and tolerable ischaemic times improve, utilisation of DCD hearts will continue to grow.

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Evolution of heart transplantation since Barnard’s first

Cited by 13 publications

References 52 publications

Heart transplantation at the Peruvian National Heart Institute: One‐decade single‐center experience

Heart transplantation at the Peruvian National Heart Institute: One‐decade single‐center experience

Heart transplantation at the Peruvian National Heart Institute: One-decade single-center experience

Donation After Circulatory Death: A New Frontier

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