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Journal articles on the topic 'Donor hearts'

Author: Grafiati
Published: 4 June 2021
Last updated: 20 February 2023

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1

Akande, Oluwatoyin, Qun Chen, Stefano Toldo, Edward J. Lesnefsky, and Mohammed Quader. "Ischemia and reperfusion injury to mitochondria and cardiac function in donation after circulatory death hearts- an experimental study." PLOS ONE 15, no. 12 (December 28, 2020): e0243504. http://dx.doi.org/10.1371/journal.pone.0243504.

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The ultimate treatment for patients with end-stage heart failure is heart transplantation. The number of donor hearts which are primarily procured from donation after brain death (DBD) donors is limited, but donation after circulatory death (DCD) donor hearts can increase the heart donor pool. However, ischemia and reperfusion injuries associated with the DCD process causes myocardial damage, limiting the use of DCD hearts in transplantation. Addressing this problem is critical in the exploration of DCD hearts as suitable donor hearts for transplantation. In this study, rat hearts were procured following the control beating-heart donor (CBD) or DCD donation process. Changes in mitochondria and cardiac function from DCD hearts subjected to 25 or 35 minutes of ischemia followed by 60 minutes of reperfusion were compared to CBD hearts. Following ischemia, rates of oxidative phosphorylation and calcium retention capacity were progressively impaired in DCD hearts compared to CBD hearts. Reperfusion caused additional mitochondrial dysfunction in DCD hearts. Developed pressure, inotropy and lusitropy, were significantly reduced in DCD hearts compared to CBD hearts. We, therefore, suggest that interventional strategies targeted before the onset of ischemia and at reperfusion could protect mitochondria, thus potentially making DCD hearts suitable for heart transplantation.
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2

Large, Stephen, and Simon Messer. "Machine Perfusion of the Human Heart." Transplantology 3, no. 1 (March 18, 2022): 109–14. http://dx.doi.org/10.3390/transplantology3010011.

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This brief communication about machine perfusion of potential human donor hearts describes its historical development. Included in the review are both the isolated perfusion of donor hearts retrieved from heart beating and non-heart-beating donors. Additionally, some detail of in-situ (within the donor body) normothermic regional reperfusion of the heart and other organs is given. This only applies to the DCD donor heart. Similarly, some detail of ex-situ (outside the body) heart perfusion is offered. This article covers the entire history of the reperfusion of donor hearts. It takes us up to the current day describing 6 years follow-up of these donor machine perfused hearts. These clinical results appear similar to the outcomes of heart beating donors if reperfusion is managed within 30 min of normothermic circulatory determined death. Future developments are also offered. These are 3-fold and include: i. the pressing need for objective markers of the clinical outcome after transplantation, ii. the wish for isolated heart perfusion leading to improvement in donor heart quality, and iii. a strategy to safely lengthen the duration of isolated heart perfusion.
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3

Quader, Mohammed, Luke Wolfe, Gundars Katlaps, and Vigneshwar Kasirajan. "Donor Heart Utilization following Cardiopulmonary Arrest and Resuscitation: Influence of Donor Characteristics and Wait Times in Transplant Regions." Journal of Transplantation 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/519401.

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Background. Procurement of hearts from cardiopulmonary arrest and resuscitated (CPR) donors for transplantation is suboptimal. We studied the influences of donor factors and regional wait times on CPR donor heart utilization.Methods. From UNOS database (1998 to 2012), we identified 44,744 heart donors, of which 4,964 (11%) received CPR. Based on procurement of heart for transplantation, CPR donors were divided into hearts procured (HP) and hearts not procured (HNP) groups. Logistic regression analysis was used to identify predictors of heart procurement.Results. Of the 4,964 CPR donors, 1,427 (28.8%) were in the HP group. Donor characteristics that favored heart procurement include younger age (25.5 ± 15 yrs versus 39 ± 18 yrs,P≤0.0001), male gender (34% versus 23%,P≤0.0001), shorter CPR duration (<15 min versus >30 min,P≤0.0001), and head trauma (60% versus 15%). Among the 11 UNOS regions, the highest procurement was in Region 1 (37%) and the lowest in Region 3 (24%). Regional transplant volumes and median waiting times did not influence heart procurement rates.Conclusions. Only 28.8% of CPR donor hearts were procured for transplantation. Factors favoring heart procurement include younger age, male gender, short CPR duration, and traumatic head injury. Heart procurement varied by region but not by transplant volumes or wait times.
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4

Shudo, Yasuhiro, Rhodalene Benjamin-Addy, Tiffany K. Koyano, William Hiesinger, John W. MacArthur, and Y. Joseph Woo. "Donors after circulatory death heart trial." Future Cardiology 17, no. 1 (January 2021): 11–17. http://dx.doi.org/10.2217/fca-2020-0070.

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Orthotopic heart transplantation is the gold standard treatment for end-stage heart failure. However, the persistent shortage of available donor organs has resulted in an ever-increasing waitlist and longer waiting periods for transplantation. On the contrary, increasing the number of heart transplants by preserving extended criteria donors and donation after circulatory death hearts with the Organ Care System™ (OCS) Heart System has the potential to provide the gold standard, life-saving treatment to patients with end-stage heart failure. The objective of the Donation After Circulatory Death Heart Trial is to evaluate the effectiveness of the OCS Heart System to preserve and assess hearts donated after circulatory death for transplantation to increase the pool of donor hearts available for transplantation, which can potentially provide patients with end-stage heart failure with the life-saving treatment. Clinical Trial Registration: NCT03831048 ( ClinicalTrials.gov )
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5

Patel, Manish, Khashayar K. Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, and Igor D. Gregoric. "Bioprosthetic Aortic Valve Replacement in a Donor Heart before Orthotopic Heart Transplantation." Texas Heart Institute Journal 44, no. 2 (April 1, 2017): 135–37. http://dx.doi.org/10.14503/thij-16-5789.

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Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia. He was not a candidate for repeat revascularization or myocardial ablation, so he was placed on the heart-transplant list as status 1A. On intra-aortic balloon pump support, the patient waited 51 days for a donor match to be identified. Despite the donor heart's having moderate aortic valve regurgitation, the decision was made to use that heart. We performed a back-table aortic valve replacement with a 23-mm St. Jude Epic bioprosthesis, and then performed the orthotopic heart transplantation. The patient did well and was discharged from the hospital on postoperative day 11. This case indicates that expanding donor criteria to include otherwise healthy hearts with certain aortic valve defects is feasible, if surgical experience and expertise permit.
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6

Poleschenko, Ya I., E. S. Protsak, D. A. Druzhininsky, M. M. Galagoudza, S. M. Minasian, Yu Yu Borshchev, A. B. Kurilov, and D. L. Sonin. "Methodology of asystolic donor heart’s condition study in an experiment using small laboratory animals." Translational Medicine 8, no. 5 (December 18, 2021): 50–56. http://dx.doi.org/10.18705/2311-4495-2021-8-5-50-56.

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In transplantation, there has always been an acute problem of the discrepancy between the number of donor organs and the number of recipients, including donor hearts. There are various ways to increase the pool of donor organs, one of them is the use of asystolic or non-heart-beating donors. Due to poor myocardial tolerance of ischemia during the asystole period, as well as because of the difficulties in diagnosing cardiac diseases of the asystolic donor, which can be contraindication to transplantation. Therefore, an in-depth study of the state of the myocardium in asystolic donors is required. Currently, there is no generally accepted protocol for working with asystolic heart donors. This protocol should include methods of heart conditioning and assessing of myocardium state. For its development we need more experimental and preclinical studies. A protocol for such a study is proposed. The modeling of an asystolic donor using rats is described on the basis of experimental work carried out by a team of authors. The article describes the following technical aspects: anesthetic guidance, asystole detection criterion, maintaining the rat body temperature in accordance with the human body temperature during cardiac arrest, surgical aspects of performing the main experimental model. The Langendorff model of isolated cardiac perfusion was chosen as the main model for assessing the state of the myocardium of a small laboratory animal. Intra-left ventricular pressure, volume of coronary blood flow, heart rate and the presence of post-reperfusion arrhythmias were selected as criteria for assessing the state of donor hearts. Assessment of the volume of damage to the donor heart is carried out using triphenyltetrazolium chloride staining of the donor organ.
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7

Poptsov, V. N., E. A. Spirina, V. V. Pchelnikov, S. G. Ukhrenkov, S. A. Masyutin, V. Yu Voronkov, E. A. Aliev, and S. Yu Ustin. "Perioperative period in cardiac transplantation from donors with brain death due to methanol poisoning." Russian Journal of Transplantology and Artificial Organs 19, no. 1 (April 14, 2017): 41–46. http://dx.doi.org/10.15825/1995-1191-2017-1-41-46.

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The successful use of donor hearts from people died of methanol poisoning helps reducing the deficit of donor organs for patients requiring urgent cardiac transplantation [3]. We present our experience of successful cardiac transplantations from 2 donors who died due to methanol poisoning. Given the possibility of performing a cardiac transplant from this group of donors a protocol has been developed at the V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian Federation which includes clinical, laboratory and instrumental criteria for the selection of heart donor and recipient. The possibility of delayed onset myocardial contractile dysfunction due to methanol poisoning means that a longer conditioningperiod is vital as well as compulsory clinical, laboratory and expert chocardiographic examinations of the potential donor heart.
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8

Druzhininsky, D. A., Ya I. Poleschenko, E. S. Protsak, M. M. Galagoudza, S. M. Minasian, Yu Yu Borshev, A. A. Kutenkov, and D. L. Sonin. "Research efficiency of hypothermia prfusion of donor visceral cavities with circulatory arrest to prolong myocardium vital capacity of donor heart in experiment." Regional blood circulation and microcirculation 21, no. 1 (April 11, 2022): 65–70. http://dx.doi.org/10.24884/1682-6655-2022-21-1-65-70.

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Introduction. In transplantology, there has always been a problem of organ donor shortage, especially hearts. One of the possible ways to increase the pool of donor hearts is to use donors with circulatory arrest, however irreversible changes in the myocardium after circulatory arrest progress rapidly, which significantly complicates the use of a heart removed from an asystolic donor for transplantation. Objective. To evaluate the effectiveness of hypothermic perfusion of visceral cavities (HPVC) as a method of prolonging the viability of the myocardium of the donor heart during asystole. Materials and methods. The experiments were performed on male rats weighing 200–250 g. The animals were divided into 5 groups, deepening on the duration of HPVC, carried out after a 10-minute period of normothermal asystole: control – 0 min. HPVC and groups with HPVC lasting 30, 60, 90 and 120 min. After complete of perfusion of the heart cavities, they were connected to a Langendorff apparatus to evaluate functional parameters and then determine the volume of necrosis. Results. By the tenth minute of the asystole, the core temperature of the rats’ body was 37.2 ± 0.3 °C. The size of necrosis in the control group was 4.1± 0.6 %. In the groups with a duration of HPVC of 30, 60, and 90 minutes, the size of necrosis was significantly higher than in the control (p<0.05), and was 13.4±3.6 %, 10.3±4.4 % and 14.1±3.4 %, respectively, but there were no difference between these groups. There was a significant increase of the necrosis size in the group with HPVC lasting 120 min compared with the HPVC lasting 90 minutes (24.2±7.1 %, p><0.05). Conclusions. Cold perfusion of the visceral cavities of an asystolic donor, initiated 10 minutes after circulatory arrest, can significantly slow the progression of irreversible myocardial damage in up to 90 minutes, which can expand the potential for the use of hearts from asystolic donors.>< 0.05), and was 13.4±3.6 %, 10.3±4.4 % and 14.1±3.4 %, respectively, but there were no difference between these groups. There was a significant increase of the necrosis size in the group with HPVC lasting 120 min compared with the HPVC lasting 90 minutes (24.2±7.1 %, p< 0.05). Conclusions. Cold perfusion of the visceral cavities of an asystolic donor, initiated 10 minutes after circulatory arrest, can significantly slow the progression of irreversible myocardial damage in up to 90 minutes, which can expand the potential for the use of hearts from asystolic donors.
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9

Poptsov, V. N., V. M. Zakharevich, E. A. Spirina, N. N. Koloskova, V. V. Pchelnikov, V. M. Khatutskii, A. I. Skokova, et al. "Perioperative period in heart transplantation with extremely prolonged ischemic times (>6 hours)." Russian Journal of Transplantology and Artificial Organs 24, no. 3 (August 24, 2022): 64–73. http://dx.doi.org/10.15825/1995-1191-2022-3-64-73.

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Amidst the shortage in viable donor hearts, the use of hearts from expanded criteria donors, including those with prolonged ischemic time, remains one of the real ways to increase the donor pool and number of heart transplantations (HTx) performed. The study included 38 recipients (33 (86.8%) men and 5 (13.2%) women) aged 11 to 66 (44.7 ± 12.0 years, median 48.0 years), who underwent primary (n = 37; 97.4%) or repeat (n = 1; 2.6%) HTx (retransplantation). Donor hearts (n = 38) with ischemic time ranged from 362 (6 hours 2 minutes) to 571 (9 hours 31 minutes) or 407 ± 52 minutes (median 400 minutes). In 33 (86.8%) of 38 recipients, the early posttransplant period was characterized by satisfactory initial graft function. Five (13.1%) recipients developed severe primary graft dysfunction, requiring post-transplant venoarterial extracorporeal membrane oxygenation (VA-ECMO) (n = 4; 10.5%) or prolongation of pre-transplant VA-ECMO within 8 days of HTx (n = 1; 2.6%). In-hospital mortality was 7.9% (n = 3). Thirty-five (92.1%) of 38 recipients were discharged from the hospital. Three recipients died in the post-hospital period at day 734, 944, and 2146 after HTx. Thirty-two (84.2%) of the 38 recipients remained alive at the end of the study. Our own experience shows that HTx from donors with prolonged ischemic time could be effective.
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10

Ghodsizad, Ali, Viktor Bordel, Matthias Ungerer, Matthias Karck, Raffi Bekeredjian, and Arjang Ruhparwar. "Ex Vivo Coronary Angiography of a Donor Heart in the Organ Care System." Heart Surgery Forum 15, no. 3 (June 14, 2012): 161. http://dx.doi.org/10.1532/hsf98.20111146.

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The international demand for donor hearts for transplantation is steadily increasing. Thus, longer transportation distances and explantation from sites with limited abilities for preexplantation diagnostics have to be considered. The development of the Organ Care System� (OCS) (TransMedics, Andover, MA, USA) may extend the extracorporeal period, with the possibility to constantly evaluate and interact during organ transport. One of the potential advantages of the OCS� is the ability to even perform coronary angiography of the donor heart, if a preexplantation angiography evaluation is not possible at the donor hospital and if significant evidence for coronary artery disease in the donor heart becomes known, because of the donor's medical history or after palpation of sclerotic coronary ostia. In this report, we present the first ex vivo coronary angiography evaluation of a potential donor heart that was performed in the OCS�. Upon explantation of the donor heart, sclerosis of the left coronary artery was palpated. After reaching the implantation site, a coronary angiography was performed by placing the OCS� on a catheterization table and inserting a 6F sheath into the access site of the OCS�. A 6F guide catheter was used to intubate the left coronary ostium. Injection of contrast agent led to strong contrast for visualization of the left coronary system. This procedure allowed sufficient assessment of the coronary arteries, which showed a slight diffuse sclerosis without any significant stenosis. This report demonstrates the advantage of the OCS� in the complex assessment of donor hearts after explantation. While the donor heart is still in the OCS�, not only is it possible to measure metabolic parameters and pressures, but even coronary angiography is feasible. With the increasing international demand for donor organs, such ex vivo examinations might play a more important role, because longer transportation distances can be accepted and organs from suboptimal donors without preexplantation diagnostics may be considered at donor sites with limited diagnostic options.
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11

Lopes, Maurício M., Gustavo C. A. Ribeiro, Thais F. Tornatore, Carolina F. M. Z. Clemente, Vicente P. A. Teixeira, and Kleber G. Franchini. "Increased expression and phosphorylation of focal adhesion kinase correlates with dysfunction in the volume-overloaded human heart." Clinical Science 113, no. 4 (July 13, 2007): 195–204. http://dx.doi.org/10.1042/cs20070036.

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FAK (focal adhesion kinase) has been shown to mediate the hypertrophic growth of the left ventricle. Experimental results also suggest that FAK may contribute to the structural and functional deterioration of the chronically overloaded left ventricle. In the present study, we postulated that FAK expression and phosphorylation may be altered in the volume-overloaded heart in humans. FAK expression and phosphorylation at Tyr397 were detected by Western blotting and immunohistochemistry in samples from endomyocardial biopsies from patients with MR (mitral regurgitation; n=21) and donor subjects (n=4). Hearts from patients with MR had degenerated cardiac myocytes and areas of fibrosis. In this group, the myocardial collagen area was increased (18% in MR hearts compared with 3% in donor hearts respectively) and correlated negatively with left ventricular ejection fraction (r=−0.74; P>0.001). FAK expression and phosphorylation at Tyr397 (a marker of the enzyme activity) were increased in samples from MR hearts compared with those from donor hearts (3.1- and 4.9-fold respectively). In myocardial samples from donor hearts, anti-FAK staining was almost exclusively restricted to cardiac myocytes; however, in myocardial samples from MR hearts, staining with the anti-FAK antibody was found to occur in myocytes and the interstitium. There was a positive correlation between collagen and the interstitial areas stained with the anti-FAK antibody (r=0.76; P>0.001). Anti-FAK and anti-vimentin staining of the interstitial areas of samples from MR hearts were extensively superimposed, indicating that most of the interstitial FAK was located in fibroblasts. In conclusion, FAK expression and phosphorylation are increased and may contribute to the underlying structural and functional abnormalities in the volume-overloaded heart in humans.
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Audam, Timothy N., Yibing Nong, Alex Tomlin, Andrea Jurkovic, Hong Li, Xiaoping Zhu, Bethany W. Long, et al. "Cardiac mesenchymal cells from failing and nonfailing hearts limit ventricular dilation when administered late after infarction." American Journal of Physiology-Heart and Circulatory Physiology 319, no. 1 (July 1, 2020): H109—H122. http://dx.doi.org/10.1152/ajpheart.00114.2020.

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Most preclinical studies have used only cells from healthy, nonfailing hearts. Whether donor condition (i.e., heart failure) impacts cells used for cell therapy is not known. We directly tested whether donor condition impacted the reparative effects of cardiac mesenchymal cells in a chronic model of myocardial infarction. Although cells from failing hearts differed in multiple aspects, they retained the potential to limit ventricular remodeling.
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Senaldi, Eric. "Donor recruitment: motivate their hearts." Annals of Blood 4 (August 2019): 19. http://dx.doi.org/10.21037/aob.2019.07.04.

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14

Macdonald, Peter S. "Machine Perfusion of Donor Hearts." Journal of Cardiac Failure 28 (2022): 9. http://dx.doi.org/10.1016/j.cardfail.2022.07.021.

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15

Robicsek, Francis. "Cadaver hearts as donor grafts." Transplant International 9, no. 4 (July 1996): 438. http://dx.doi.org/10.1111/j.1432-2277.1996.tb00907.x.

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16

Owen, Virginia J., Paul B. J. Burton, Martin C. Michel, Oliver Zolk, Michael Böhm, John R. Pepper, Paul J. R. Barton, Magdi H. Yacoub, and Sian E. Harding. "Myocardial Dysfunction in Donor Hearts." Circulation 99, no. 19 (May 18, 1999): 2565–70. http://dx.doi.org/10.1161/01.cir.99.19.2565.

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17

Tixier, Denis, Georg Matheis, Gerald D. Buckberg, and Helen H. Young. "Donor hearts with impaired hemodynamics." Journal of Thoracic and Cardiovascular Surgery 102, no. 2 (August 1991): 207–14. http://dx.doi.org/10.1016/s0022-5223(19)36553-5.

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18

Freundt, Miriam, Alois Philipp, Philipp Kolat, Leopold Rupprecht, Christine Friedrich, Stephan Hirt, and Assad Haneya. "Impact of Elevated Donor Troponin I as Predictor of Adverse Outcome in Adult Heart Transplantation: A Single-center Experience." Thoracic and Cardiovascular Surgeon 66, no. 05 (September 18, 2017): 417–24. http://dx.doi.org/10.1055/s-0037-1606363.

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Background Due to globally increasing donor organ shortage, investigation of previously described risk factors for utilizing marginal donor hearts is needed. The aim of this study was to determine the impact of elevated donor serum troponin I (TnI) levels on outcome after heart transplantation (HTx). Methods Between January 1996 and August 2013, 161 patients were reviewed for donor TnI serum levels (>0.3 ng/mL was considered elevated), postoperative outcome parameters, 30-day mortality, and 1-, 3-, and 5-year survival. Results TnI levels were elevated in 45 (28.0%) donors. Recipients of hearts with elevated TnI had higher incidence of postoperative systolic dysfunction, prolonged inotropic support, prolonged mechanical ventilation, and longer intensive care unit (ICU) stay (p < 0.001). This group had higher 30-day mortality (22.2% vs 8.6%, p = 0.03) and lower 1-, 3-, and 5-year survival (56%, 53%, and 50% versus 82%, 76%, and 69%, p = 0.032). Elevated TnI was the only independent risk factor for 30-day mortality (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.28–10.27, p = 0.015). Conclusions Elevated donor TnI serum concentration seems to be a marker for adverse outcome and increased short- and long-term mortality after HTx. Nevertheless, many other perioperative variables and parameters can be associated with outcome.
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Roth, Sebastian, René M’Pembele, Anthony Nucaro, Alexandra Stroda, Theresa Tenge, Giovanna Lurati Buse, Stephan U. Sixt, et al. "Impact of Cardiopulmonary Resuscitation of Donors on Days Alive and Out of Hospital after Orthotopic Heart Transplantation." Journal of Clinical Medicine 11, no. 13 (July 3, 2022): 3853. http://dx.doi.org/10.3390/jcm11133853.

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Background: The number of patients waiting for heart transplantation (HTX) is increasing. Optimizing the use of all available donor hearts is crucial. While mortality seems not to be affected by donor cardiopulmonary resuscitation (CPR), the impact of donor CPR on days alive and out of hospital (DAOH) is unclear. Methods: This retrospective study included adults who underwent HTX at the University Hospital Duesseldorf, Germany from 2010–2020. Main exposure was donor-CPR. Secondary exposure was the length of CPR. The primary endpoint was DAOH at one year. Results: A total of 187 patients were screened and 171 patients remained for statistical analysis. One-year mortality was 18.7%. The median DAOH at one year was 295 days (interquartile range 206–322 days). Forty-two patients (24.6%) received donor-CPR hearts. The median length of CPR was 15 (9–21) minutes. There was no significant difference in DAOH between patients with donor-CPR hearts versus patients with no-CPR hearts (CPR: 291 days (211–318 days) vs. no-CPR: 295 days (215–324 days); p = 0.619). Multivariate linear regression revealed that there was no association between length of CPR and DAOH (unstandardized coefficients B: −0.06, standard error: 0.81, 95% CI −1.65–1.53, p = 0.943). Conclusions: Donor CPR status and length of CPR are not associated with reduced DAOH at one year after HTX.
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Zeng, Zifeng, Liwei Xu, Yu Xu, Yongsheng Ruan, Deshen Liu, Jiale Li, Chuanjie Niu, Shaoyi Zheng, Pengyu Zhou, and Zezhou Xiao. "Normothermic Ex Vivo Heart Perfusion with Mesenchymal Stem Cell-Derived Conditioned Medium Improves Myocardial Tissue Protection in Rat Donation after Circulatory Death Hearts." Stem Cells International 2022 (November 17, 2022): 1–12. http://dx.doi.org/10.1155/2022/8513812.

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Objective. Adopting hearts from donation after circulatory death (DCD) is a promising approach to enlarge the donor pool. Nevertheless, DCD hearts experience severe warm ischemia/reperfusion (I/R) injury. Recent studies have demonstrated that conditioned medium (CM) derived from bone marrow mesenchymal stem cells (BMSCs) has the potential of reducing organ I/R injury. Therefore, we investigated whether DCD heart preservation with normothermic ex vivo heart perfusion (EVHP) and BMSCs-CM treatment could alleviate myocardial warm I/R injury in the DCD hearts. Methods. We randomly divided donor rats into two groups: (1) DCD-Control group and (2) DCD-CM group. Before DCD heart preservation with the normothermic EVHP system for 105 minutes, rats suffered from a 25-minute warm ischemia injury in the DCD procedure. Vehicle or CM (300 μl) was added to the perfusate at the beginning of the perfusion process. The cardiac function of DCD hearts in the DCD-Control and DCD-CM groups was measured every 30 minutes. Besides, non-DCD hearts were harvested from the beating-heart rats. Results. The antibody array demonstrated that the CM contained 14 bioactive factors involved in apoptosis, inflammation, and oxidative stress. Warm ischemia injury resulted in a significant increase in the level of oxidative stress, inflammation, and apoptosis in the DCD hearts of DCD-Control group. Furthermore, compared with the DCD-Control group, CM treatment increased the developed pressure, dP / d t max and dP / d t min of the left ventricular in the DCD hearts during a 90-minute EVHP. Moreover, the administration of CM attenuated the level of oxidative stress, inflammation, and apoptosis in the DCD hearts of the DCD-CM group. Conclusions. Normothermic EVHP combined with CM treatment can alleviate warm I/R injury in the DCD hearts by decreasing the level of oxidative stress, inflammatory response, and apoptosis, which might alleviate the shortage of donor hearts by adopting DCD hearts.
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Dickson, Eric W., Mojca Lorbar, William A. Porcaro, Richard A. Fenton, Christopher P. Reinhardt, Anne Gysembergh, and Karin Przyklenk. "Rabbit heart can be “preconditioned” via transfer of coronary effluent." American Journal of Physiology-Heart and Circulatory Physiology 277, no. 6 (December 1, 1999): H2451—H2457. http://dx.doi.org/10.1152/ajpheart.1999.277.6.h2451.

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Brief myocardial ischemia not only evokes a local cardioprotective or “preconditioning” effect but also can render remote myocardium resistant to sustained ischemia. We propose the following hypotheses: remote protection is initiated by a humoral trigger; brief ischemia-reperfusion will result in release of the humoral trigger (possibly adenosine and/or norepinephrine) into the coronary effluent; and transfer of this effluent to a virgin acceptor heart will elicit cardioprotection. To test these concepts, effluent was collected during normal perfusion from donor-control hearts and during preconditioning ischemia-reperfusion from donor-preconditioned (PC) hearts. After reoxygenation occurred and aliquots for measurement of adenosine and norepinephrine content were harvested, effluent was transfused to acceptor-control and acceptor-PC hearts. All hearts then underwent 40 min of global ischemia and 60 min of reperfusion, and infarct size was delineated by tetrazolium staining. Mean infarct size was smaller in both donor- and acceptor-PC groups (9% of left ventricle) than in donor- and acceptor-control groups (36% and 34%; P < 0.01). Protection in acceptor-PC hearts could not, however, be attributed to adenosine or norepinephrine. Thus preconditioning-induced cardioprotection can be transferred between rabbit hearts by transfusion of coronary effluent. Although adenosine and norepinephrine are apparently not responsible, these results suggest that remote protection is initiated by a humoral mechanism.
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Zuckermann, A., and G. Laufer. "Rationale limits of organ donor maximization for heart transplantation." Russian Journal of Transplantology and Artificial Organs 20, no. 4 (January 31, 2019): 142–45. http://dx.doi.org/10.15825/1995-1191-2018-4-142-145.

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Cardiac transplantation is an established therapy for end-stage heart failure. The number of heart transplant procedures performed worldwide has remained relatively unchanged in recent years. Although mortality rates on the waiting list have improved due to improved ventricular assist devices and rhythm correction techniques, it remains imperative to maximize use of all potential donor hearts. The recipient now presents with multiple complexities. The continued divergence between the rising number of transplant candidates added to the transplant waiting list and the number of suitable organ donors has increased pressure on clinicians to maximize the use of available thoracic organs for transplantation.
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Christmas, A. Britton, Tyson A. Bogart, Kristina E. Etson, Brett A. Fair, Harold R. Howe, David G. Jacobs, and Ronald F. Sing. "The Reward is Worth the Wait: A Prospective Analysis of 100 Consecutive Organ Donors." American Surgeon 78, no. 3 (March 2012): 296–99. http://dx.doi.org/10.1177/000313481207800336.

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Aggressive donor management protocols have evolved to maximize the number of procured organs. Our study assessed donor management time and the number and types of organs procured with the hypothesis that shorter management time yields increased organ procurement and transplant rates. We prospectively analyzed 100 donors managed by a regional organ procurement organization (OPO) during 2007 to 2008. Data included patient demographics, number and types of organs procured and transplanted, patient management time by the OPO, and achievement of donor pre-procurement goals. One hundred consecutive organ donors were managed with a mean age 41 ± 18 years and mean management time 23 ± 9 hours; 376 organs were procured and 327 successfully transplanted. Donors managed greater than 20 hours yielded significantly more heart (5 vs 26, P < 0.01) and lung (6 vs 40, P < 0.01) procurements, more organs procured per donor (3.2 ± 1.4 vs 4.2 ± 1.6, P < 0.01), and more organs transplanted per donor (2.6 ± 1.5 vs 3.7 ± 1.8, P < 0.01) than those managed 20 hours or less. No difference in the attainment of donor management goals was observed between these populations. Contrary to our initial hypothesis, donor management times greater than 20 hours yielded increased organ procurement and transplant rates, particularly for hearts and lungs, despite no differences in the achievement of donor preprocurement management goals.
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Neligan, S., P. Whitmore, M. J. Fenton, M. Eliott, and M. Burch. "Use of marginal donor hearts in paediatric heart recipients." Journal of Heart and Lung Transplantation 23, no. 2 (February 2004): S50. http://dx.doi.org/10.1016/j.healun.2003.11.026.

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Fiore, Antonio, Antonino Massimiliano Grande, Giuseppe Gatti, Amir Youssari, Mariantonietta Piscitelli, Eric Bergoend, Nicolas Mongardon, Julien Ternacle, and Jean-Paul Couetil. "Valvular surgery in donor hearts before orthotopic heart transplantation." Archives of Cardiovascular Diseases 113, no. 11 (November 2020): 674–78. http://dx.doi.org/10.1016/j.acvd.2020.05.010.

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26

Miranda, Luiz Eduardo Correia, Francisco Igor Bulcão de Macedo, Olival Cirilo Lucena Fonseca Neto, and Cláudio Moura Lacerda. "Use of extended criteria of donors in liver transplantation." Brazilian Journal of Transplantation 10, no. 3 (June 1, 2007): 774–48. http://dx.doi.org/10.53855/bjt.v10i3.342.

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The use of marginal/extended criteria for organ donors is a solution to the problem of organ donors shortage, and since its use has become more common worldwide, concerns on the effectiveness of such organs and the outcomes of the liver transplantation (LT) have been raised. In spite of the importance of the term, there is no consensus on the features of the marginal donors. Some parameters related to the features of those donors were found to have negative consequences: increasing donor or recipient age, longer cold ischemia time, hypotension and inotropic support, gender mismatch, after cardiac death donation, hearts that stopped beating, non-heart-beating donors, and macrosteatosis. This paper discusses some controversial issues found in the literature, and shares our experience related to the use of marginal/extended criteria of donor in liver transplantation.
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Jacobbi, L. M., V. McBride, K. Like, and D. Rose. "Increasing the donor pool: Recovery of hearts from older donors." Transplantation Proceedings 29, no. 8 (December 1997): 3297–98. http://dx.doi.org/10.1016/s0041-1345(97)00917-2.

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28

Popov, M. A., D. V. Shumakov, D. I. Zybin, and E. G. Agafonov. "Revisiting the transplantation of donor heart with left ventricular myocardial hypertrophy." Transplantologiya. The Russian Journal of Transplantation 12, no. 1 (March 18, 2020): 42–48. http://dx.doi.org/10.23873/2074-0506-2020-12-1-42-48.

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Despite the widespread use of mechanical circulatory support systems, modern optimal drug therapy and various interventional methods of heart transplantation remain the "gold standard" for the treatment of end-stage heart failure patients.At the same time the required number of heart transplants is significantly increasing due to the progressively increasing number of patients needing transplants and the actual donor pool. In recent years there has been a trend towards the increase in the number of recipients and the decrease in the number of donor organs. However, the use of donor hearts with pathological changes, including left ventricular myocardial hypertrophy, remains a controversial topic. It is believed that the use of expanded criteria significantly increases the risk of graft failure in the post-transplant period and leads to deterioration of immediate and long-term results. This work aimed to analyze the data on using donor hearts with left ventricular myocardial hypertrophy for allotransplantation.Authors declare no conflict of interest.
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29

Broadley, Kenneth J., and Alan L. Rothaul. "Relationships between cardiac hyperactivity, oxygen tension, and release of vasodilator material in coronary autoregulation of guinea-pig hearts." Canadian Journal of Physiology and Pharmacology 64, no. 4 (April 1, 1986): 388–97. http://dx.doi.org/10.1139/y86-063.

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Increases in cardiac activity induce autoregulatory coronary vasodilation. The intermediate steps which trigger this process are thought to be myocardial hypoxia which induces the release of vasodilator mediator(s). The present study examines the relationships between mechanical activity, oxygen tension, and release of vasodilator material in isolated perfused hearts. Guinea-pig isolated hearts were perfused in series, the effluent from donor hearts being regassed prior to entry to recipient hearts. Histamine (1 μg) and isoproterenol (10 ng) increased the rate and tension of donor hearts and produced predominant coronary vasodilator responses which were followed by the appearance of vasodilator material in the recipient (falls in perfusion pressure, 9.8 ± 1.1 and 9.1 ± 2.5 mmHg) (1 mmHg = 133.322 Pa). Exposure of donor hearts to hypoxia also caused vasodilatation and release of vasodilator material (fall in pressure, 11.4 ± 1.6 mmHg). Pacing-induced tachycardia (6 Hz) of donor hearts promoted the release of vasodilator material, the fall in recipient heart pressure being 11.5 ± 1.8 mmHg. This was abolished by β-adrenoceptor blockade and when donor hearts were from reserpine-pretreated guinea pigs. In was concluded that pacing released endogenous catecholamines which in turn released the vasodilator material. Pacing per se did not cause vasodilatation or release of the vasodilator. The [Formula: see text] of perfusates from donor hearts was reduced by pacing at 5 Hz (25.7 ± 5.2 mmHg) and by isoproterenol (10 ng, 32.0 ± 3.7 mmHg), indicative of an elevated oxygen extraction. The isoproterenol-induced falls in [Formula: see text] were abolished by β-adrenoceptor blockade. However, the pacing-induced falls in [Formula: see text] persisted, the values occurring before (25.7 ± 5.2 mmHg) and after propranolol (45.7 ± 4.5 mmHg) and before (32.1 ± 1.1 mmHg) and after practolol (27.3 ± 4.1 mmHg) not differing significantly (p > 0.05). These falls in perfusate [Formula: see text] were not accompanied by coronary vasodilatation or release of vasoactive material. Perfusate [Formula: see text] changes could therefore be dissociated from the coronary vasodilatation and vasoactive material release, suggesting that hypoxia may not be a prerequisite for the metabolic autoregulatory vasodilatation in response to myocardial hyperactivity induced by cardiac stimulants.
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30

Russell, P. S., C. M. Chase, H. J. Winn, and R. B. Colvin. "Coronary atherosclerosis in transplanted mouse hearts. II. Importance of humoral immunity." Journal of Immunology 152, no. 10 (May 15, 1994): 5135–41. http://dx.doi.org/10.4049/jimmunol.152.10.5135.

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Abstract Obstructive lesions in arterial vessels of transplanted organs constitute an important factor in the late failure of these organs, especially for the heart. The absence of obstructive lesions in syngeneic donor-recipient combinations, suggests that they depend upon recipient immune responsiveness. It is controversial whether humoral or cellular aspects of the immune response predominate in the process. The present experiments employed hearts transplanted between inbred mice. After brief preoperative immunosuppression of recipients with mAbs to CD4 and CD8 determinants, hearts transplanted between mice incompatible for histocompatibility Ags survived for prolonged periods and most developed typical, obstructive coronary lesions. Our quantitative scoring of vascular changes on tissue sections of excised hearts, grades both their severity and prevalence. Transplants between strains that produced Abs to donor cells (B10.A to B10.BR), developed coronary lesions exceeding those in the reverse combination in which no detectable Ab was formed (B10.BR to B10.A; p &lt; 0.00001), even though their histoincompatibility was similar. Treatment of B10.A recipients of B10.BR hearts with an antiserum against the donor significantly increased coronary lesions (p &lt; 0.0003) in a dose-dependent fashion. Coronary arteries of B10.BR hearts transplanted to C.B-17 SCID mice remained largely free of lesions, whereas transplants to SCID recipients that received continuing injections of an antiserum directed to Ags of the donor developed striking, obstructive coronary lesions. We conclude that humoral immunity can be the prime instigator of atheromatous changes that occur in transplanted hearts.
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31

Koerner, Michael M. "Good News for Donor Hearts: Postconditioning." Transplantation 84, no. 11 (December 2007): 1382–83. http://dx.doi.org/10.1097/01.tp.0000288806.02437.5e.

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32

Johnson, Charles E., Sherry C. Faulkner, Juan Tucker, Michael L. Schmitz, Roger BB Mee, and Jonathan J. Drummond-Webb. "Optimizing cardioplegia strategy for donor hearts." Perfusion 19, no. 1 (January 2004): 65–68. http://dx.doi.org/10.1191/0267659104pf701oa.

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33

Melo, J. L., A. R. Paulo, J. A. Souza, L. A. Ohe, M. B. Barbosa, M. S. Avila, F. G. Marcondes-Braga, et al. "Frofile of Donor Hearts in Brazil." Journal of Heart and Lung Transplantation 33, no. 4 (April 2014): S265—S266. http://dx.doi.org/10.1016/j.healun.2014.01.701.

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34

Reich, Heidi J., Jon A. Kobashigawa, Tamar Aintablian, Danny Ramzy, Michelle M. Kittleson, and Fardad Esmailian. "Effects of Older Donor Age and Cold Ischemic Time on Long-Term Outcomes of Heart Transplantation." Texas Heart Institute Journal 45, no. 1 (February 1, 2018): 17–22. http://dx.doi.org/10.14503/thij-16-6178.

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Using older donor hearts in cardiac transplantation may lead to inferior outcomes: older donors have more comorbidities that reduce graft quality, including coronary artery disease, hypertension, diabetes mellitus, and dyslipidemia. Shorter cold ischemic times might overcome the detrimental effect of older donor age. We examined the relationship between donor allograft age and cold ischemic time on the long-term outcomes of heart transplant recipients. rom 1994 through 2010, surgeons at our hospital performed 745 heart transplantations. We retrospectively classified these cases by donor ages of &lt;50 years (younger) and ≥50 years (older), then by cold ischemic times of &lt;120 min (short), 120 to 240 min (intermediate), and &gt;240 min (long). Endpoints included recipient and graft survival, and freedom from cardiac allograft vasculopathy, nonfatal major adverse cardiac events, and rejection. For intermediate ischemic times, the 5-year recipient survival rate was lower when donors were older (70% vs 82.6%; P=0.02). This was also true for long ischemic times (69.8% vs 87.6%; P=0.09). For short ischemic times, we found no difference in 5-year recipient or graft survival rates (80% older vs 85.6% younger; P=0.79), in freedom from nonfatal major adverse cardiac events (83.3% vs 91.5%; P=0.46), or in freedom from cardiac allograft vasculopathy (50% vs 70.6%; P=0.66). Rejection rates were mostly similar. Long-term graft survival in heart transplantation patients with older donor allografts may improve when cold ischemic times are shorter.
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35

Sen, Luyi, Yoo-Sun Hong, Haimin Luo, Guanggen Cui, and Hillel Laks. "Efficiency, efficacy, and adverse effects of adenovirus- vs. liposome-mediated gene therapy in cardiac allografts." American Journal of Physiology-Heart and Circulatory Physiology 281, no. 3 (September 1, 2001): H1433—H1441. http://dx.doi.org/10.1152/ajpheart.2001.281.3.h1433.

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Virus- and nonvirus-mediated immunosuppressive cytokine gene therapy prolongs cardiac allograft survival in various nonfunctional heart transplant animal models, but its cardiac adverse effects have not been addressed. Recently, we developed a functional heterotopic heart transplant model in rabbits. For the first time, we were able to systematically compare the efficiency, efficacy, and adverse effects of optimized adenovirus- and liposome-mediated ex vivo interleukin (IL)-10 gene transfer in functional donor hearts. The efficiency of liposome-mediated gene transfer was greatly improved in physiologically functioning donor hearts and was only three- to fourfold lower than adenovirus-mediated gene transfer. The efficacy of liposome-mediated IL-10 gene transfer was much higher than that mediated by adenovirus. Significant negative inotropic and arrhythmogenic adverse effects on transplanted hearts were observed due to viral cytotoxicity and immunogenesis, which greatly abated the therapeutic efficacy of this first generation adenovirus-mediated gene therapy.
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36

Palmer, Sarah Jane. "Keeping donor hearts beating: the ‘heart in a box’ arrives." British Journal of Cardiac Nursing 13, no. 5 (May 2, 2018): 254–55. http://dx.doi.org/10.12968/bjca.2018.13.5.254.

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37

Korkmaz, Sevil, Susanne Bährle-Szabó, Sivakkanan Loganathan, Shiliang Li, Matthias Karck, and Gábor Szabó. "Marginal donors: can older donor hearts tolerate prolonged cold ischemic storage?" Aging Clinical and Experimental Research 25, no. 5 (August 15, 2013): 597–600. http://dx.doi.org/10.1007/s40520-013-0131-9.

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38

Gibson, Patrick H., Fernando Riesgo, Jonathan B. Choy, Daniel H. Kim, and Harald Becher. "Dobutamine stress echocardiography after cardiac transplantation: implications of donor–recipient age difference." Echo Research and Practice 2, no. 2 (June 2015): 65–71. http://dx.doi.org/10.1530/erp-15-0006.

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Dobutamine stress echocardiography (DSE) is widely used during follow-up after cardiac transplant for the diagnosis of allograft vasculopathy. We investigated the effect of donor–recipient age difference on the ability to reach target heart rate (HR) during DSE.All cardiac transplant patients who were undergoing DSE over a 3-year period in a single institution were reviewed. Target HR was specified as 85%×(220 – patient age). Further patient and donor demographics were obtained from the local transplant database.61 patients (45 male, 55±12 years) were stressed with a median dose of 40 mcg/kg per min dobutamine. Only 37 patients (61%) achieved target HR. Donor hearts were mostly younger (mean 41±14 years, P<0.001), with only 11 patients (18%) having donors who were older than they were. Patients with older donors required higher doses of dobutamine (median 50 vs 30 mcg/kg per min, P<0.001) but achieved a lower percentage target HR (mean 93% vs 101%, P=0.003) than those with younger donors did. Patients with older donors were less likely to achieve target HR (18% vs 67%, P=0.003).In conclusion, donor–recipient age difference affects the likelihood of achieving target HR and should be considered when a patient is consistently unable to achieve ‘adequate’ stress according to the patient's age.
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39

DePasquale, E. C., C. J. Lum, R. Chand, W. Ragalie, A. Chang, A. Salimbangon, M. Deng, et al. "Use of Donor HCV NAT Positive Hearts: Expanding the Donor Pool?" Journal of Heart and Lung Transplantation 38, no. 4 (April 2019): S47—S48. http://dx.doi.org/10.1016/j.healun.2019.01.103.

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40

White, Christopher W., Emma Ambrose, Alison Müller, Yun Li, Hoa Le, Brett Hiebert, Rakesh Arora, et al. "Assessment of donor heart viability during ex vivo heart perfusion." Canadian Journal of Physiology and Pharmacology 93, no. 10 (October 2015): 893–901. http://dx.doi.org/10.1139/cjpp-2014-0474.

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Ex vivo heart perfusion (EVHP) may facilitate resuscitation of discarded donor hearts and expand the donor pool; however, a reliable means of demonstrating organ viability prior to transplantation is required. Therefore, we sought to identify metabolic and functional parameters that predict myocardial performance during EVHP. To evaluate the parameters over a broad spectrum of organ function, we obtained hearts from 9 normal pigs and 37 donation after circulatory death pigs and perfused them ex vivo. Functional parameters obtained from a left ventricular conductance catheter, oxygen consumption, coronary vascular resistance, and lactate concentration were measured, and linear regression analyses were performed to identify which parameters best correlated with myocardial performance (cardiac index: mL·min–1·g–1). Functional parameters exhibited excellent correlation with myocardial performance and demonstrated high sensitivity and specificity for identifying hearts at risk of poor post-transplant function (ejection fraction: R2 = 0.80, sensitivity = 1.00, specificity = 0.85; stroke work: R2 = 0.76, sensitivity = 1.00, specificity = 0.77; minimum dP/dt: R2 = 0.74, sensitivity = 1.00, specificity = 0.54; tau: R2 = 0.51, sensitivity = 1.00, specificity = 0.92), whereas metabolic parameters were limited in their ability to predict myocardial performance (oxygen consumption: R2 = 0.28; coronary vascular resistance: R2 = 0.20; lactate concentration: R2 = 0.02). We concluded that evaluation of functional parameters provides the best assessment of myocardial performance during EVHP, which highlights the need for an EVHP device capable of assessing the donor heart in a physiologic working mode.
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41

Huffman, Lynn C., Sheryl E. Koch, and Karyn L. Butler. "Coronary effluent from a preconditioned heart activates the JAK-STAT pathway and induces cardioprotection in a donor heart." American Journal of Physiology-Heart and Circulatory Physiology 294, no. 1 (January 2008): H257—H262. http://dx.doi.org/10.1152/ajpheart.00769.2007.

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Preconditioning (PC) protects against ischemia-reperfusion (I/R) injury via the activation of the JAK-STAT pathway. We hypothesized that the mediators responsible for PC can be transferred to naive myocardium through the coronary effluent. Langendorff-perfused hearts from male Sprague-Dawley rats were randomized to paired donor/acceptor protocols with or without PC in the presence or absence of the JAK-2 inhibitor AG-490 ( n = 6 for each group). Warmed, oxygenated coronary effluent collected during the reperfusion phases of PC (3 cycles of 5 min ischemia and 5 min reperfusion) was administered to acceptor hearts. The hearts were then subjected to 30 min ischemia and 40 min reperfusion. The left ventricles were analyzed for phosphorylated (p)STAT-1, pSTAT-3, Bax, Bcl, Bcl-XL/Bcl-2-associated protein (BAD), and caspase-3 expression by Western blot. A separate group of hearts ( n = 6) was analyzed for STAT activation immediately after the transfer of the PC effluent (no I-R). Baseline cardiodynamics were not different among the groups. End-reperfusion maximal change in pressure over time (+dP/d tmax) was significantly ( P < 0.05) improved in acceptor PC (3,637 ± 199 mmHg/s) and donor PC (4,304 ± 347 mmHg/s) hearts over non-PC donor (2,020 ± 363 mmHg/s) and acceptor (2,624 ± 345 mmHg/s) hearts. Similar differences were seen for minimal change in pressure over time (−dP/d tmin). STAT-3 activation was significantly increased in donor and acceptor PC hearts compared with non-PC hearts. Conversely, pSTAT-1 and Bax expression was decreased in donor and acceptor PC hearts compared with non-PC hearts. No differences in Bcl, BAD, or caspase-3 expression were observed. Treatment with AG-490 attenuated the recovery of ±dP/d t in acceptor PC hearts and significantly reduced pSTAT-3 expression. The PC coronary effluent activates JAK-STAT signaling, limits apoptosis, and protects myocardial performance from I/R injury.
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42

Pizanis, N., A. Dimitriou, A. Koch, G. Ayoub, P. Luedike, M. Papathanasiou, A. Ruhparwar, B. Schmack, A. Weymann, and M. Kamler. "Introduction of Machine Perfusion in Donor Hearts." Journal of Heart and Lung Transplantation 40, no. 4 (April 2021): S195. http://dx.doi.org/10.1016/j.healun.2021.01.567.

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43

Venkateswaran, Rajamiyer, Robert Bonser, and Richard Steeds. "Echocardiographic detection of dysfunctions in donor hearts." Future Cardiology 3, no. 1 (January 2007): 99–104. http://dx.doi.org/10.2217/14796678.3.1.99.

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44

Frigerio, Maria. "Optimal and Equitable Allocation of Donor Hearts." Transplantation Direct 3, no. 8 (August 2017): e197. http://dx.doi.org/10.1097/txd.0000000000000712.

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45

Guglin, M., H. R. Omar, and C. Wright. "Underutilization of Donor Hearts: An Observational Study." Transplantation Proceedings 50, no. 10 (December 2018): 3698–704. http://dx.doi.org/10.1016/j.transproceed.2018.06.019.

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46

Sumida, S., K. Ebine, S. Tamura, M. Lee, and K. Sato. "Viability of supercooled donor hearts for transplantation." Cryobiology 24, no. 6 (December 1987): 570–71. http://dx.doi.org/10.1016/0011-2240(87)90133-7.

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47

Zhulkov, M. O., A. V. Fomichev, S. A. Alsov, E. N. Cleaver, and A. M. Chernyavsky. "Current state of the problem and results of ex vivo perfusion of donor hearts." Russian Journal of Transplantology and Artificial Organs 21, no. 4 (February 2, 2020): 143–46. http://dx.doi.org/10.15825/1995-1191-2019-4-143-146.

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Patients with drug refractory end-stage heart failure fall into the severe category of cardiological patients. Numerous studies have shown the superior efficacy of heart transplantation over other treatments for end-stage chronic heart failure. However, despite decades of achievements in transplantology, shortage of donor organs remains a pressing and unresolved issue. The only way to reduce shortage of donor organs is to use donors with advanced criteria, which requires the use of latest technologies in organ resuscitation and conditioning.
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48

TAZELAAR, HENRY D., and WILLIAM D. EDWARDS. "Pathology of Cardiac Transplantation: Recipient Hearts (Chronic Heart Failure) and Donor Hearts (Acute and Chronic Rejection)." Mayo Clinic Proceedings 67, no. 7 (July 1992): 685–96. http://dx.doi.org/10.1016/s0025-6196(12)60726-5.

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49

Möllhoff, T., S. Sukehiro, M. Borgers, G. Vandeplassche, H. Van Belle, H. Van Aken, and W. Flameng. "Influence of Superoxide Dismutase on Reperfusion Injury in Donor Hearts Preserved with Bretschneider-HTK Cardioplegic Solution." Cardiovascular Surgery 1, no. 4 (August 1993): 357–61. http://dx.doi.org/10.1177/096721099300100408.

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The ability of superoxide dismutase to prevent reperfusion injury after long-term cold storage of donor hearts was evaluated in canine hearts. Whole blood reperfusion was performed using a «support animal’. Twelve dog hearts were arrested by a single dose of Bretschneider cardioplegic solution and stored cold (0.5°C) for 24h. Thereafter they were reperfused for 60 min without ( n = 6) or with ( n = 6) superoxide dismutase treatment. Myocardial tissue biopsies were taken for determination of high-energy phosphates before explantation, after the preservation period and during reperfusion. Early reperfusion in both groups resulted in an initial recovery of high-energy phosphates and was followed by a decrease during the subsequent reperfusion phase. The latter was associated with the appearance of left ventricular contracture, and cessation of heart beat. Electron microscopic examination of the myocardial tissues after reperfusion revealed a severe reperfusion injury in both groups. It is concluded, that in donor hearts preserved with Bretschneider solution, reperfusion injury cannot be prevented by administration via the perfusate of superoxide dismutase.
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50

Michaelides, Alexia, and Willie Koen. "Effect of Donor Selection on the Early Outcome of Heart Transplant Recipients." Progress in Transplantation 15, no. 1 (March 2005): 24–26. http://dx.doi.org/10.1177/152692480501500104.

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Recipients receiving heart transplants from 83 donors from 1995 to 2002 were analyzed to evaluate the effect of various donor factors on recipient outcomes. The 83 donors (13 women and 70 men; 2–51 years old) had cold ischemic times ranging between 55 and 287 minutes. Donor age, cause of death, inotropic support, and cold ischemic times of the hearts were compared to 1-year left ventricular ejection fraction, permanent pacemaker dependency, 30-day mortality, and 1-year survival in the recipients. Donors receiving low-dose inotropic support resulted in recipients with permanent pacemaker dependency in 14.8%, and 30-day mortality and 1-year survival rates of 7.4% and 70.3%, respectively. Donors not receiving inotropic support resulted in recipients with permanent pacemaker dependency in 3.5%, and 30-day mortality and 1-year survival of 3.5% and 83.9%, respectively. Cold ischemic times less than or equal to 120 minutes showed 30-day mortality and 1-year survival rates of 0% and 90.9%, respectively. Cold ischemic times equal to or more than 121 minutes showed 30-day mortality and 1-year survival rates of 8% and 76%, respectively. Increased donor age ( P=.22) and cold ischemic time showed an increase in mortality without affecting mean ejection fraction in survivors. Use of inotropic support in donors ( P=.95) showed an increase in mortality without affecting mean ejection fraction in survivors.
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