Resuscitation, preservation, and evaluation of hearts donated after circulatory death: an avenue to expand the donor pool for transplantation
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Date
2016-03, 2013-07, 2015-01, 2015-05, 2016-03, 2017-01
Authors
White, Christopher W.
Journal Title
Journal ISSN
Volume Title
Publisher
John Wiley and Sons
Elsevier
Elsevier
NRC Research Press
John Wiley and Sons
Elsevier
Elsevier
Elsevier
NRC Research Press
John Wiley and Sons
Elsevier
Abstract
Cardiac 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.
Description
Keywords
Heart transplantation, Organ donation, Organ preservation, Ex vivo heart perfusion, Donation after circulatory death
Citation
White et al. American Journal of Transplantation 2016, 16 (3): 783 - 793
White et al. The Journal of Heart and Lung Transplantation 2013, 32 (7): 734 - 743
White et al. The Journal of Heart and Lung Transplantation 2015, 34 (1): 113 - 121
White et al. Canadian Journal of Physiology and Pharmacology 2015, 93 (10): 893 - 901
White et al. American Journal of Transplantation 2015, 16 (3): 773 - 782
White et al. The Annals of Thoracic Surgery 2017, 103(1):122-130
White et al. The Journal of Heart and Lung Transplantation 2013, 32 (7): 734 - 743
White et al. The Journal of Heart and Lung Transplantation 2015, 34 (1): 113 - 121
White et al. Canadian Journal of Physiology and Pharmacology 2015, 93 (10): 893 - 901
White et al. American Journal of Transplantation 2015, 16 (3): 773 - 782
White et al. The Annals of Thoracic Surgery 2017, 103(1):122-130