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Case Reports
. 2023 Mar 2:19:80-85.
doi: 10.1016/j.xjtc.2023.02.015. eCollection 2023 Jun.

First-in-human beating-heart transplant

Aravind Krishnan  1 , Patpilai Kasinpila  1 , Hanjay Wang  1 , Chawannuch Ruaengsri  1 , Yasuhiro Shudo  1 , Ethan Jackson  2 , Y Joseph Woo  1
Affiliations
Case Reports

First-in-human beating-heart transplant

Aravind Krishnan et al. JTCVS Tech. .
No abstract available

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Figures

None
Modifications to the OCS to permit beating heart transplant.
Figure 1
Figure 1
Recipient cardiectomy and modified OCS configuration. A, Recipient pericardial well showing the aortic cannula, cross-clamp, venous drainage cannulas, and cardiotomy suckers. B, Donor heart on OCS in standard configuration, warm blood is perfused directly through the aorta. There is a pulmonary artery vent and a left atrial drainage cannula. C, Our modification to the OCS to allow for uninterrupted coronary perfusion. A root vent is now sewn into the donor aorta, and cardiotomy suckers are added to the left atrium and now-opened right atrium. Two epicardial pacing wires are also sewn onto the heart. D, A cross-clamp is applied, and now perfusion is exclusively provided by the cardiopulmonary bypass circuit, with care taken to leave enough aorta to sew to for aortic anastomosis.
Figure E1
Figure E1
The TransMedics Organ Care System (OCS) configuration (adapted from Alomari and colleaguesE2). The standard configuration for OCS is demonstrated here, where antegrade perfusion is provided through the aorta, the pulmonary artery is a proxy for coronary artery perfusion, and a left ventricular vent is usually placed through the left atrium to vent the heart. BP, Blood pressure; LV, left ventricle.
See this image and copyright information in PMC

References

    1. Dharmavaram N., Hess T., Jaeger H., Smith J., Hermsen J., Murray D., et al. National trends in heart donor usage rates: are we efficiently transplanting more hearts? J Am Heart Assoc. 2021;10 doi: 10.1161/JAHA.120.019655. - DOI - PMC - PubMed
    1. Jawitz O.K., Raman V., DeVore A.D., Mentz R.J., Patel C.B., Rogers J., et al. Increasing the United States heart transplant donor pool with donation after circulatory death. J Thorac Cardiovasc Surg. 2020;159:e307. doi: 10.1016/J.JTCVS.2019.09.080. - DOI - PMC - PubMed
    1. OCS for HCPs - Transmedics. https://www.transmedics.com/ocs-hcp/
    1. Shudo Y., Wang H., Woo Y.J. A modified technique for orthotopic heart transplantation to minimize warm ischaemic time. Eur J Cardio Thorac Surg. 2018;53:1089–1090. doi: 10.1093/EJCTS/EZX411. - DOI - PubMed
    1. Alomari M., Garg P., Yazji J.H., Wadiwala I.J., Alamouti-fard E., Hussain M.W.A., et al. Is the organ care system (OCS) still the first choice with emerging new strategies for donation after circulatory death (DCD) in heart transplant? Cureus. 2022;14 doi: 10.7759/CUREUS.26281. - DOI - PMC - PubMed

E-References

    1. Shudo Y., Hiesinger W., Oyer P.E., Woo Y.J. Operative technique and pitfalls in donor heart procurement. Asian Cardiovasc Thorac Ann. 2017;25:80–82. doi: 10.1177/0218492316678716. - DOI - PubMed
    1. Alomari M., Garg P., Yazji J.H., Wadiwala I.J., Alamouti-fard E., Hussain M.W.A., et al. Is the organ care system (OCS) still the first choice with emerging new strategies for donation after circulatory death (DCD) in heart transplant? Cureus. 2022;14 doi: 10.7759/CUREUS.26281. - DOI - PMC - PubMed
    1. Dashkevich A., Raissadati A., Syrjälä S.O., Zarkada G., Keränen M.A., Tuuminen R., et al. Ischemia-reperfusion injury enhances lymphatic endothelial VEGFR3 and rejection in cardiac allografts. Am J Transplant. 2016;16:1160–1172. doi: 10.1111/AJT.13564. - DOI - PubMed
    1. Lee J.C., Christie J.D. Primary graft dysfunction. Proc Am Thorac Soc. 2009;6:39–46. doi: 10.1513/PATS.200808-082GO. - DOI - PubMed
    1. Silvis M.J.M., Kaffka genaamd Dengler S.E., Odille C.A., Mishra M., van der Kaaij N.P., Doevendans P.A., et al. Damage-associated molecular patterns in myocardial infarction and heart transplantation: the road to translational success. Front Immunol. 2020;11:1. doi: 10.3389/FIMMU.2020.599511. - DOI - PMC - PubMed

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