Surgery Updates of Heart Transplantation in Children and Adults

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 612

Special Issue Editor


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Guest Editor
Department of Surgery, Division of Anatomy, USUHS, Bethesda, MD 20814, USA
Interests: general surgery; cardiac surgery; reconstructive surgery; anatomical variations in surgery; heart transplantation

Special Issue Information

Dear Colleagues,

Surgery updates in heart transplantation for both children and adults have significantly advanced the field of cardiac transplantation. Heart transplantation remains the gold standard treatment for end-stage heart failure when medical management is no longer effective. Recent developments in surgical techniques, immunosuppressive therapies and organ preservation have improved outcomes and expanded the eligibility criteria for transplantation in both pediatric and adult populations.

In children, advancements in donor–recipient size matching, innovative surgical approaches and improved post-transplant care have increased survival rates and enhanced the long-term quality of life. Additionally, the use of ventricular assist devices as a bridge to transplantation has become more common in pediatric patients with severe heart failure.

For adults, advancements include extended donor criteria, such as the use of marginal donors and the development of minimally invasive techniques, reducing surgical trauma and improving recovery times. Furthermore, personalized immunosuppressive regimens and improved management of complications have contributed to better graft survival and overall patient outcomes.

These surgery updates in heart transplantation for both children and adults have revolutionized the field, offering new hope and improved outcomes for patients with end-stage heart failure. Ongoing research and technological advancements continue to drive progress in this vital area of cardiac surgery.

Dr. Elizabeth J. Maynes
Guest Editor

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Keywords

  • cardiac surgery
  • heart transplantation
  • heart failure
  • surgical techniques
  • heart diseases
  • heart injuries
  • solid organ transplantation
  • donor–recipient size matching
  • minimally invasive techniques
  • general surgery

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Published Papers (1 paper)

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Research

14 pages, 1344 KiB  
Article
Expanding Horizons in Cardiac Transplant: Efficacy and Outcomes of Circulatory and Brain Death Donor Hearts in a Newly Implemented Cardiac Transplant Program with Limited Donor Accessibility and a Literature Review
by Maria del Val Groba Marco, Miriam Cabrera Santana, Mario Galvan Ruiz, Miguel Fernandez de Sanmamed, Jose Luis Romero Lujan, Jesus Maria Gonzalez Martin, Luis Santana Ortega, María Vazquez Espinar, Francisco Portela Torron, Vicente Peña Morant, Eduardo Jose Caballero Dorta and Antonio Garcia Quintana
J. Clin. Med. 2024, 13(17), 4972; https://doi.org/10.3390/jcm13174972 - 23 Aug 2024
Viewed by 437
Abstract
(1) Background: Cardiac donation after circulatory death (DCD) is an emerging paradigm in organ transplantation. However, this technique is recent and has only been implemented by highly experienced centers. This study compares the characteristics and outcomes of thoraco-abdominal normothermic regional perfusion (TANRP) and [...] Read more.
(1) Background: Cardiac donation after circulatory death (DCD) is an emerging paradigm in organ transplantation. However, this technique is recent and has only been implemented by highly experienced centers. This study compares the characteristics and outcomes of thoraco-abdominal normothermic regional perfusion (TANRP) and static cold-storage DCD and traditional donation after brain death (DBD) cardiac transplants (CT) in a newly stablished transplant program with restricted donor availability. (2) Method: We performed a retrospective, single-center study of all adult patients who underwent a CT between November 2019 and December 2023, with a follow-up conducted until August 2024. Data were retrieved from medical records. A review of the current literature on DCD CT was conducted to provide a broader context for our findings. The primary outcome was survival at 6 months after transplantation. (3) Results: During the study period, 76 adults (median age 56 years [IQR: 50–63 years]) underwent CT, and 12 (16%) were DCD donors. DCD donors had a similar age (46 vs. 47 years, p = 0.727), were mostly male (92%), and one patient had left ventricular dysfunction during the intraoperative DCD process. There were no significant differences in recipients’ characteristics. Survival was similar in the DCD group compared to DBD at 6 months (100 vs. 94%) and 12 months post-CT survival (92% vs. 94%), p = 0.82. There was no primary graft dysfunction in the DCD group (9% in DBD, p = 0.581). The median total hospital stay was longer in the DCD group (46 vs. 21 days, p = 0.021). An increase of 150% in transplantation activity due to DCD was estimated. (4) Conclusions: In a new CT program that utilized older donors and included recipients with similar illnesses and comorbidities, comparable outcomes between DCD and DBD hearts were observed. DCD was rapidly incorporated into the transplant activity, demonstrating an expedited learning curve and significantly increasing the availability of donor hearts. Full article
(This article belongs to the Special Issue Surgery Updates of Heart Transplantation in Children and Adults)
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