Spring AM, Gjelaj C, Madan S, Patel SR, Saeed O, Murthy S, Rochlani Y, Sims DB, Vukelic S, Forest SJ, Borgi JF, Goldstein DJ, Jorde UP. Evolution of heart transplant donor characteristics in the 21st century: A United States single center’s experience. World J Transplant 2024; 14(3): 92721 [DOI: 10.5500/wjt.v14.i3.92721]
Corresponding Author of This Article
Ulrich P Jorde, MD, Professor, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, MMC-MAP Room 7, Bronx, NY 10467, United States. ujorde@montefiore.org
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 18, 2024; 14(3): 92721 Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.92721
Evolution of heart transplant donor characteristics in the 21st century: A United States single center’s experience
Alexander M Spring, Christiana Gjelaj, Shivank Madan, Snehal R Patel, Omar Saeed, Sandhya Murthy, Yogita Rochlani, Daniel B Sims, Sasha Vukelic, Stephen J Forest, Jamil F Borgi, Daniel J Goldstein, Ulrich P Jorde
Alexander M Spring, Christiana Gjelaj, Shivank Madan, Snehal R Patel, Omar Saeed, Sandhya Murthy, Yogita Rochlani, Daniel B Sims, Sasha Vukelic, Stephen J Forest, Daniel J Goldstein, Ulrich P Jorde, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States
Jamil F Borgi, Division of Cardiothoracic Surgery, Tulane University, New Orleans, LA 70112, United States
Author contributions: Spring AM and Jorde UP conceptualized the study; Spring AM, Gjelaj C, Madan S, Patel SR, Saeed O, Murthy S, Rochlani Y, Sims DB, Vukelic S, Forest SJ, Borgi JF, Goldstein DJ, and Jorde UP reviewed and revised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ulrich P Jorde, MD, Professor, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, MMC-MAP Room 7, Bronx, NY 10467, United States. ujorde@montefiore.org
Received: February 3, 2024 Revised: May 3, 2024 Accepted: June 7, 2024 Published online: September 18, 2024 Processing time: 178 Days and 11.5 Hours
Abstract
Despite a record setting number of heart transplants performed annually, the national donor shortage continues to plague transplant teams across the United States. Here we describe the barriers to adaptation of numerous “non-traditional” orthotopic heart transplant donor characteristics including donors with hepatitis C virus, those meeting criteria for donation after cardiac death, donors with coronavirus disease 19 infection, donors with the human immunodeficiency virus, and grafts with left ventricular systolic dysfunction. Our center’s objective was to increase our transplant volume by expanding our donor pool from “traditional” donors to these “non-traditional” donors. We detail how medical advances such as certain laboratory studies, pharmacologic interventions, and organ care systems have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.
Core Tip: Since the turn of the 21st century, advances in certain laboratory studies, pharmacologic interventions, and organ care systems have led to the expansion of the donor pool in the field of orthotopic heart transplantation. This includes: (1) Nucleic acid testing and direct acting antivirals for donors with hepatitis C virus; (2) Organ care systems for donors who meet criteria for donation after cardiac death; (3) Anti-viral therapies for donors with coronavirus disease 19; (4) Improved donor management for grafts with left ventricular systolic dysfunction; and (5) Better understanding of immunosuppression and medication interaction in patients with human immunodeficiency virus. We detail how these advances have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.
