Hearts from Donation after Circulatory Death (DCD) Could Potentially Increase Transplants by 15 Percent
Study shows DCD hearts are a viable option for transplantation
MONTREAL, April 25, 2013 – The results of a pre-clinical study show the viability of using hearts from donation after circulatory (or cardiac) Death (DCD) will be revealed today at the International Society for Heart and Lung Transplantation (ISHLT) 33rd Annual Meeting and Scientific Sessions in Montreal, Canada. The study focused on investigating the impact of varying periods of warm ischemia (is-KEE-mee-uh) (WI), cardiac function and evaluating pharmacological strategies to limit ischemic injury to the heart.
By evaluating how long the heart can remain healthy after being removed from its blood supply, clinicians can determine if DCD is a viable source for donor hearts. According to the ISHLT Registry data, which tracks heart transplants around the world, a reported 3,742 heart transplants occurred worldwide in 2010. In the U.S., the United Network of Organ Sharing (UNOS) indicates the number of heart transplants is approximately 2,300 annually.
Using various factors of predictability including past experiences with DCD lung transplantation, donor demographics, using a warm ischemia time (WIT) of 30 minutes and donors less than 50 years of age, clinicians estimate the number of heart transplants could potentially increase by 15 percent using hearts from DCD donors.
“Results from our pre-clinical study confirm the viability and potential for full functional recovery of DCD hearts following exposure of up 30 minutes warm ischemia time,” said Arjun Iyer, M.D. at the Victor Chang Cardiac Research Institute in Darlinghurst, Australia. “Use of the clinically approved Transmedics Organ Care System device allows preservation of these hearts for up to four hours replicating the amount of time an organ is in transport.”
During the pre-clinical study, groups of hearts that received supplemented Celsior, an organ preservation solution supplemented with pharmacological agents to activate ischemic post-conditioning strategies, saw a decrease in ischemia and reperfusion injury, and resulted in improvement in recovery post WI. Without supplementation the effects of WI beyond 20 minutes is detrimental to the organ and limits its potential for transplantation.
Part two of the pre-clinical work will be presented this evening at 6 p.m. EDT at the ISHLT Annual Meeting and will include Recovery of DCD hearts on to the Transmedics OCS after 30 min WIT. Human clinical trials will begin in the near future, pending approval.
The International Society for Heart and Lung Transplantation (ISHLT) is a not-for-profit professional organization with more than 2,700 members from over 45 countries dedicated to improving the care of patients with advanced heart or lung disease through transplantation, mechanical support and innovative therapies via research, education and advocacy. For more information, visit www.ishlt.org.
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