Review of Current Normothermic Regional Perfusion Practice in Pediatric Cardiac Donation.
| Title: | Review of Current Normothermic Regional Perfusion Practice in Pediatric Cardiac Donation. |
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| Authors: | Overbey DM; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, North Carolina. Electronic address: douglas.overbey@duke.edu.; Stephens EH; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Parent B; Department of Population Health, NYU Langone Health, New York, North Carolina.; Ameduri RK; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.; Catarino PA; Department of Cardiac Surgery, Cedars Sinai Medical Center, Los Angeles, California.; Needle J; Department of Pediatrics, Center for Bioethics, University of Minnesota, Minneapolis, Minnesota.; Kucera JA; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, North Carolina.; Kaldas FM; Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.; Biniwale R; Division of Cardiothoracic Surgery, Department of Surgery, UCLA Health Sciences, Los Angeles, California.; Turek JW; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina; Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, North Carolina. |
| Source: | The Annals of thoracic surgery [Ann Thorac Surg] 2025 Jul; Vol. 120 (1), pp. 4-14. Date of Electronic Publication: 2024 Dec 16. |
| Publication Type: | Journal Article; Review; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Elsevier; Original Publication: Boston. |
| MeSH Terms: | Heart Transplantation*/methods ; Perfusion*/methods ; Tissue and Organ Procurement*/methods ; Tissue and Organ Procurement*/ethics ; Organ Preservation*/methods; Humans ; Child |
| Abstract: | Background: Cardiac allotransplantation is the optimal treatment for end-stage heart failure. However, organ supply remains the principal issue affecting patients. Pediatric patients present unique challenges resulting in long wait-list times and increased mortality. Donation after circulatory death with normothermic regional perfusion represents a method to increase the number of available organs in this population.; Methods: Multiinstitutional expert consultation was sought to outline extant technical, ethical, and logistical issues with regard to normothermic regional perfusion cardiac donation techniques. Specific advantages in the pediatric population are highlighted, as well as technical considerations resulting in successful organ procurement.; Results: The use of donation after circulatory death organs after normothermic regional perfusion in the United States is increasing and offers advantages to the pediatric heart failure population. Ethical reservations both nationally and abroad persist, namely pertaining to cerebral blood flow. This issue has led to variation in perception and use of normothermic regional perfusion, thus contributing to a discrepancy between donor and recipient locations. Procurement techniques and variations are described, with an introduction to program planning and protocol development. Training in technical aspects of the procedure is paramount for both the surgeon and support staff to construct a successful program, along with transparent protocols to mitigate ethical concerns.; Conclusions: Normothermic regional perfusion is relevant after donation after cardiac death in the pediatric population. Ethical and technical challenges remain, in concert with substantial domestic and international variation. Standardization of technique may serve to increase future use and increase the number of available hearts for transplantation, thereby reducing pediatric mortality.; (Copyright © 2025. Published by Elsevier Inc.) |
| Competing Interests: | Disclosures The authors have no conflicts of interest to disclose. |
| Entry Date(s): | Date Created: 20241218 Date Completed: 20250625 Latest Revision: 20260505 |
| Update Code: | 20260506 |
| DOI: | 10.1016/j.athoracsur.2024.11.026 |
| PMID: | 39694216 |
| Database: | MEDLINE |
Journal Article; Review; Research Support, Non-U.S. Gov't