Donation after circulatory death (DCD) donors have expanded the heart transplant donor pool. Current DCD recovery strategies typically require donor heart reanimation but remain limited by logistical complexity, cost, and ethical concerns. These challenges are further amplified in heart-lung transplantation. Although brain-dead donors (DBD) have historically been the primary source of heart-lung blocs, successful DCD heart-lung transplantation has recently been reported. However, most cases rely on thoracoabdominal normothermic regional perfusion (TA-NRP), which has limited global adoption and raises concerns regarding ethical considerations and lung utilization. Rapid recovery with extended ultra-oxygenation preservation (REUP) has recently emerged as an alternative strategy for DCD heart recovery without pre-implant reanimation. In this report, we describe the first application of the REUP technique in concert with direct lung procurement to recover an en bloc heart-lung, enabling successful combined heart-lung transplantation with excellent early graft function.
Dereshgi et al. (Thu,) studied this question.
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