Donor supply for partial heart transplantation in the United States.
Donor supply for partial heart transplantation in the United States.
复制标题
美国部分心脏移植的供体供应。
DOI：
10.1111/ctr.15060
复制
发表时间：
2023
影响因子：
2.1
通讯作者：
Rajab,TaufiekKonrad
中科院分区：
文献类型：
--
作者：
Quintao,Ritchelli;Kwon,JennieH;Bishara,Katherine;Rajab,TaufiekKonrad
研究背景先天性心脏病（CHD）是世界范围内出生缺陷的最常见原因。瓣膜缺损是CHD的常见形式，目前，患有不可修复瓣膜疾病的儿童的治疗选择有限。抗凝、尺寸选择和瓣膜置换术选择缺乏的问题可导致高死亡率和再次手术发生率。部分心脏移植或新鲜同种异体瓣膜移植，最近被描述为一种策略，以提供一个持久的和非血栓形成的替代传统的假体，并提供增长潜力，在儿科patients.MethodsThe器官共享联合网络（UNOS）数据库进行查询，以分析未恢复，但有可行的瓣膜（n= 3565）的儿科供体心脏的数量。2010年1月至2021年9月。可回收瓣膜按供体年龄分组：婴儿（年龄< 1岁）、幼儿（年龄≥1岁且<3岁）和儿童（年龄≥3岁且<18岁）。捐赠者的人口统计学特征进行了分析年龄groups.ResultsInfants，幼儿，和儿童共344，465，和2756心脏与可回收的瓣膜，分别在研究期间，平均29，39，和230心脏与可回收的valves per year.ConclusionThe结果，我们的研究确定了部分心脏移植的最低供体供应。实际数字可能更高，因为它包括未进入UNOS数据库的心脏和原位心脏移植受者的多米诺骨牌移植。部分心脏移植在后勤上是可行的，因为所有年龄组都有可回收的瓣膜，满足了患有不可修复瓣膜疾病的儿科患者的临床需求。
BackgroundCongenital heart disease (CHD) is the most common cause of birth defects worldwide. Valvular defects are a common form of CHDs, and, at this time, treatment options for children with unrepairable valve disease are limited. Issues with anticoagulation, sizing, and lack of growth in valve replacement options can lead to high mortality rates and incidence of reoperations. Partial heart transplantation, or transplantation of fresh valve allografts, has recently been described as a strategy to provide a durable and non‐thrombogenic alternative to conventional prostheses and provide growth potential in pediatric patients.MethodsThe United Network for Organ Sharing (UNOS) database was queried to analyze the number of pediatric donor hearts that were not recovered but had viable valves (n= 3565) between January 2010 and September 2021. Recoverable valves were grouped by donor age: infants (age < 1 year), toddlers (age ≥1 and <3 years), and children (age ≥3 and <18 years). Demographic characteristics of donors were analyzed between age groups.ResultsInfants, toddlers, and children had a total of 344, 465, and 2756 hearts with recoverable valves, respectively, over the study period, representing an average of 29, 39, and 230 hearts with recoverable valves per year.ConclusionThe results of our study identify the minimum donor supply for partial heart transplantation. The actual number is likely higher because it includes hearts not entered in the UNOS database and domino transplants from orthotopic heart transplant recipients. Partial heart transplantation is logistically feasible as there are recoverable valves available for all age groups, fulfilling a clinical need in pediatric patients with unrepairable valve disease.