Heart transplantation (HT) with grafts obtained by controlled donation after circulatory death (cDCD) has shown promising clinical results, with early and mid-term outcomes similar to donation after brain death (DBD) [1-2]. However, cDCD-HT success (both with direct organ procurement and thoraco-abdominal normothermic regional perfusion –taNRP–) has been demonstrated in countries with short asystolic ‘no-touch’ periods (e.g. five minutes for England or two minutes for Australia). Italy has one of the longest known no-touch periods for circulatory death declaration (twenty minutes), and this has been considered a major limiting factor for successful cDCD-HT. Nevertheless, cDCD- HT in Italy was approved in April 2023. Following approval from the Italian Regulatory Authority, the first cDCD-HT was performed in Padova on May 11th, 2023 [3].
Against Odds of Prolonged Warm Ischemia: Early Experience With DCD Heart Transplantation After 20-Minute No-Touch Period.
Battista Luciani G;Onorati F;Galeone A;Gottin L;
2024-01-01
Abstract
Heart transplantation (HT) with grafts obtained by controlled donation after circulatory death (cDCD) has shown promising clinical results, with early and mid-term outcomes similar to donation after brain death (DBD) [1-2]. However, cDCD-HT success (both with direct organ procurement and thoraco-abdominal normothermic regional perfusion –taNRP–) has been demonstrated in countries with short asystolic ‘no-touch’ periods (e.g. five minutes for England or two minutes for Australia). Italy has one of the longest known no-touch periods for circulatory death declaration (twenty minutes), and this has been considered a major limiting factor for successful cDCD-HT. Nevertheless, cDCD- HT in Italy was approved in April 2023. Following approval from the Italian Regulatory Authority, the first cDCD-HT was performed in Padova on May 11th, 2023 [3].
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