Successful clinical transplantation of hearts donated after circulatory death using normothermic regional perfusion
In this study we describe 2 cases of successful adult DCD HT performed at our institution using an original protocol.
Giuseppe Ristagno1*, Francesca Fumagalli1, Barbara Bottazzi2, Alberto Mantovani2,3,4, Davide Olivari1, Deborah Novelli1 and Roberto Latini1 1Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research IRCCS, Milan, Italy 2Humanitas Clinical and Research Center-IRCCS, Milan, Italy 3Humanitas University, Milan, Italy 4The William Harvey Research Institute, Queen Mary University of London, London, United Kingdom The long pentraxin PTX3 is a member of the pentraxin family produced locally by stromal and myeloid cells in response to proinflammatory signals and microbial moieties. The p...
In this study the effect of NMP perfusion fluid on survival, metabolism and function of thawed cryopreserved human (h)MSC and porcine (p)MSC in suspension conditions was studied. Suspension conditions reduced the viability of pMSC by 40% in both perfusion fluid and culture medium. Viability of hMSC was reduced by suspension conditions by 15% in perfusion fluid, whilst no differences were found in survival in culture medium. Under adherent conditions, survival of the cells was not affected by perfusion fluid. The perfusion fluid did not affect survival of fresh MSC in suspension compared to the control culture medium. The f...
Ex vivo lung perfusion (EVLP) has been proposed as a platform for lung graft assessment and preservation. However, its proinflammatory milieu may be associated with deterioration in graft quality which may contribute to posttransplant graft dysfunction. Triptolide (TL), a diterpenoid triepoxide, has recently been shown to have a therapeutic potential in various disease states due to its anti-inflammatory properties. Based on this, we sought to assess the impact of TL on graft preservation during EVLP as well as associated posttransplant outcomes.
Ex vivo lung perfusion (EVLP) enables novel therapeutic approaches to repair damaged lungs for transplantation. We investigated the concept and feasibility of elective cell therapy for donor lungs. Dosing, efficacy and transgene expression kinetics of engineered mesenchymal stromal cell therapy were examined in pig EVLP and transplantation.
In the setting of Cardiogenic Shock (CS), impaired biventricular function can lead to an acute decrease in renal function via reduced renal perfusion and increased renal venous pressure. In a nationally representative sample, we sought to analyze the characteristics and outcomes of patients hospitalized with CS requiring renal replacement therapy (hemodialysis) for acute kidney injury (AKI-HD).
The OPTN/UNOS added fields to the deceased donor registration form on 3/31/2015 and the transplants recipient registration (TRR) form on 2/28/2018 to collect data on the utilization of ex vivo lung perfusion (EVLP) on donor lung. The steadily increasing use of EVLP, early outcomes, and new data collected on the TRR are summarized.
The risk of post-transplant lymphoproliferative disorder (PTLD), a B-cell malignancy caused by Epstein-Barr virus (EBV), is highest when latent virus is transmitted from B-cells within the allograft to a na ïve recipient. Ex-vivo lung perfusion (EVLP) is a potential platform to modify grafts before transplantation. We hypothesized that EVLP-mediated delivery of Rituximab (RTX), an antibody targeting CD20+ B-cells, may safely clear latent EBV from donor lungs and attenuate viral transmission.
In pre-clinical studies we have demonstrated the ability of light-based therapies - UVC and photodynamic therapy (PDT) during EVLP to inactivate HCV in donor lungs. In a step-wise application of this technology to clinical transplantation, we designed a clinical trial to evaluate to effects of UVC treatment using NAT+ HCV donor lungs followed by transplantation.
Ex vivo lung perfusion (EVLP) has become an invaluable tool in clinical lung transplantation (LTx). EVLP has enabled the assessment and rescue of donor organs that would have otherwise been discarded for LTx; however, determining which marginal organs are suitable for transplant remains challenging and relies largely on clinical assessment expertise. To this end, we describe our efforts to develop and validate a perfusate-based diagnostic test that will assist transplant teams in the EVLP decision-making process.
To avoid asystole during the ablation of the heart to improve the viability of the heart using the normothermic perfusion in Langendorff mode as a preservation method during ablation avoiding chemical cryopreservation.