Resuscitation, preservation, and evaluation of hearts donated after circulatory death: an avenue to expand the donor pool for transplantation

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dc.contributor.authorWhite, Christopher W.
dc.contributor.examiningcommitteeTian, Ganghong (Physiology and Pathophysiology) Dhalla, Naranjan (Physiology and Pathophysiology) Arora, Rakesh (Surgery) Wigle, Jeffrey (Biochemistry and Medical Genetics) MacDonald, Peter (University of New South Wales)en_US
dc.contributor.supervisorFreed, Darren (Physiology and Pathophysiology) Hryshko, Larry (Physiology and Pathophysiology)en_US
dc.date.accessioned2017-03-29T17:46:34Z
dc.date.available2017-03-29T17:46:34Z
dc.date.issued2016-03en_US
dc.date.issued2013-07en_US
dc.date.issued2015-01en_US
dc.date.issued2015-05en_US
dc.date.issued2016-03en_US
dc.date.issued2017-01en_US
dc.degree.disciplinePhysiology and Pathophysiologyen_US
dc.degree.levelDoctor of Philosophy (Ph.D.)en_US
dc.description.abstractCardiac transplantation is the treatment of choice for eligible patients with advanced heart failure; however, it is limited by a critical shortage of suitable organs from traditional brain-dead donors. Organs donated following circulatory death (DCD) have been used to successfully expand the pool of organs available for kidney, liver, and lung transplantation; however, concerns regarding the severity of injury sustained by the heart following withdrawal of life sustaining therapy have deterred the clinical transplantation of DCD hearts. Investigations aiming to optimize the resuscitation, preservation, and evaluation of DCD hearts may facilitate the development of an evidence based protocol for DCD heart transplantation that can be translated to the clinical area and expand the donor pool. Therefore, the objectives of this thesis are to develop a clinically relevant large animal model of DCD and gain a greater understanding regarding the physiologic impact of donor extubation on the DCD heart, demonstrate as a ‘proof-of-concept’ that utilizing an approach to donor heart resuscitation, preservation, and evaluation that is tailored to the DCD context can facilitate successful transplantation, and finally to investigate ways to optimize the resuscitation, preservation, and evaluation of DCD hearts for transplantation. The results of this thesis may then be used to inform the development of an evidence-based protocol for DCD heart transplantation that can be translated to the clinical area. The clinical adoption of such a protocol has the potential to expand the donor pool and improve outcomes for patients with end-stage heart failure.en_US
dc.description.noteMay 2017en_US
dc.identifier.citationWhite et al. American Journal of Transplantation 2016, 16 (3): 783 - 793en_US
dc.identifier.citationWhite et al. The Journal of Heart and Lung Transplantation 2013, 32 (7): 734 - 743en_US
dc.identifier.citationWhite et al. The Journal of Heart and Lung Transplantation 2015, 34 (1): 113 - 121en_US
dc.identifier.citationWhite et al. Canadian Journal of Physiology and Pharmacology 2015, 93 (10): 893 - 901en_US
dc.identifier.citationWhite et al. American Journal of Transplantation 2015, 16 (3): 773 - 782en_US
dc.identifier.citationWhite et al. The Annals of Thoracic Surgery 2017, 103(1):122-130en_US
dc.identifier.urihttp://hdl.handle.net/1993/32171
dc.language.isoengen_US
dc.publisherJohn Wiley and Sonsen_US
dc.publisherElsevieren_US
dc.publisherElsevieren_US
dc.publisherNRC Research Pressen_US
dc.publisherJohn Wiley and Sonsen_US
dc.publisherElsevieren_US
dc.rightsopen accessen_US
dc.subjectHeart transplantationen_US
dc.subjectOrgan donationen_US
dc.subjectOrgan preservationen_US
dc.subjectEx vivo heart perfusionen_US
dc.subjectDonation after circulatory deathen_US
dc.titleResuscitation, preservation, and evaluation of hearts donated after circulatory death: an avenue to expand the donor pool for transplantationen_US
dc.typedoctoral thesisen_US
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