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Pediatric Heart Transplantation Outcomes Comparison Following Circulatory Death With Normothermic Regional Perfusion In Infants And Small Children
Cathlyn K. Medina, BA, Berk Aykut, MD, Lauren E. Parker, BS, Jacob N. Schroder, MD, Ziv Beckerman, MD, Joseph W. Turek, MD, MBA, PhD, Douglas M. Overbey, MD, MPH.
Duke University, Durham, NC, USA.
Objective(s): Normothermic Regional Perfusion (NRP) is gaining traction as a method of assessing cardiac function in DCD donors. However, differences in outcomes of DCD NRP donors in comparison to traditional DBD donors procured using static cold storage (SCS) remain poorly understood.
Methods: In this retrospective, single-center study, pediatric patients underwent heart transplantation from DCD or DBD donors. DCD donor hearts were reanimated
in situ utilizing a mobile extracorporeal membrane oxygenator platform for thoracic NRP and transported using SCS. A propensity-matched group of DBD SCS recipients were identified from historic controls.
Results: Our cohort included 7 DCD NRP and 7 DBD SCS recipients. Baseline differences between groups were not significant. Median donor cold ischemic time was 225 (199-284) minutes in the DCD group and 200 (169-238) minutes in the DBD group (
Table 1). Median NRP time for the DCD group was 41 (34-58) minutes. Median operative time for DCD and DBD groups were 356 (241-450) and 424 (235-538) minutes, respectively. Initial LVEDP after transplant did not vary between groups. ICU and hospital length of stays did not differ between groups. LVEF was normal in all patients at discharge. One patient in the DCD group died on POD88 due to non-cardiac causes.
Conclusions: Utilization of DCD donors procured using NRP is a promising strategy in pediatric heart transplantation and demonstrates similar outcomes to standard procurement techniques.
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