Successful transplantation of hearts harvested 30 minutes after death from exsanguination

Cardiac reanimation for donor heart transplantation after cardiocirculatory death

“…16 Although our study did not aim to determine the optimal perfusion conditions or perfusate composition, we did observe in pilot experiments that inappropriate perfusion conditions can result in a failure of the myocardium to be resuscitated. As in previously published studies, [17][18][19][20][21][22][23] we found that controlled reperfusion (utilizing an initially low coronary perfusion pressure and a low temperature before gradually increasing to physiologic levels) promoted cardiac recovery. We also incorporated leukocyte filtration and perfusate enrichment with metabolic substrates in accordance with previous studies.…”

“…We also incorporated leukocyte filtration and perfusate enrichment with metabolic substrates in accordance with previous studies. 15,[17][18][19][20][21][22][23][24] Furthermore, we included in situ myocardial cooling immediately after the standoff period to attenuate the ischemic damage suffered by the myocardium during the time taken to excise and transfer the heart to the perfusion apparatus.…”

Circulatory Load During Hypoxia Impairs Post-transplant Myocardial Functional Recovery in Donation After Cardiac Death

“…In several successful animal experiments, investigators used either exsanguination 8,15,16 or asphyxiation 6,7,17 as the mode of death. 9 yet maintains a better myocardial metabolic state than asphyxiation, 10 it was used in several previous animal experiments and some investigators have reported their results as "successful" DCD heart transplantation.…”

Heart transplantation from donation after circulatory determined death

“…The time limit of 30 minutes for FWIT is adopted from that used by abdominal transplant surgeons. However, there has been well established small and large animal models to suggest that heart would be tolerant to 30 minutes of warm ischemia (8). Although the application of this criteria is more stringent than the current protocols applied to DCD heart transplantation in the UK, this conservative projection would have translated to at least a 30% increase in heart transplant activity over the same period.…”