Nonischemic Donor Heart Preservation: New Milestone in Heart Transplantation History.
Nicola PradeganMichele GalloAssunta FabozzoGiuseppe ToscanoVincenzo TarziaNicola PradeganPublished in: ASAIO journal (American Society for Artificial Internal Organs : 1992) (2023)
Heart transplantation is considered the gold standard for the treatment of advanced end-stage heart failure. However, standard donors after brain death are decreasing, whereas patients on the heart transplant waitlist are constantly rising. The introduction of the ex vivo machine perfusion device has been a turning point; in fact, these systems are able to significantly reduce ischemic times and have a potential effect on ischemia-related damage reduction. From a clinical standpoint, these machines show emerging results in terms of heart donor pool expansion, making marginal donors and donor grafts after circulatory death suitable for donation. This article aims to review mechanisms and preclinical and clinical outcomes of currently available ex vivo perfusion systems, and to explore the future fields of application of these technologies.
Keyphrases
- heart failure
- end stage renal disease
- atrial fibrillation
- ejection fraction
- chronic kidney disease
- newly diagnosed
- cardiac resynchronization therapy
- peritoneal dialysis
- oxidative stress
- left ventricular
- magnetic resonance
- prognostic factors
- magnetic resonance imaging
- stem cells
- kidney transplantation
- cerebral ischemia
- white matter
- human health
- patient reported outcomes
- current status
- contrast enhanced
- blood brain barrier
- replacement therapy