How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program
Homograft heart valves may have significant advantages and are preferred for the repair of congenital valve malformations, especially in young women of childbearing age, athletes and in patients with active endocarditis. A growing problem, however, is the mismatch between tissue donation and the inc...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Netherlands
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126547/ https://www.ncbi.nlm.nih.gov/pubmed/37097383 http://dx.doi.org/10.1007/s10561-023-10087-z |
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author | Schmiady, Martin O. Jashari, Ramadan Lenherr, Renato Regenscheit, Stefan Hitendu, Dave Wendt, Martin Schiess, Stefanie Schweiger, Martin Hofmann, Michael Sromicki, Juri Flammer, Andreas Wilhelm, Markus J. Cesnjevar, Robert Carrel, Thierry Vogt, Paul R. Mestres, Carlos A. |
author_facet | Schmiady, Martin O. Jashari, Ramadan Lenherr, Renato Regenscheit, Stefan Hitendu, Dave Wendt, Martin Schiess, Stefanie Schweiger, Martin Hofmann, Michael Sromicki, Juri Flammer, Andreas Wilhelm, Markus J. Cesnjevar, Robert Carrel, Thierry Vogt, Paul R. Mestres, Carlos A. |
author_sort | Schmiady, Martin O. |
collection | PubMed |
description | Homograft heart valves may have significant advantages and are preferred for the repair of congenital valve malformations, especially in young women of childbearing age, athletes and in patients with active endocarditis. A growing problem, however, is the mismatch between tissue donation and the increasing demand. The aim of this paper is to describe the initiation process of a homograft procurement program to attenuate the shortage of organs. A comprehensive description of the infrastructure and procedural steps required to initiate a cardiac and vascular tissue donation program combined with a prospective follow-up of all homografts explanted at our institution. Between January 2020 and May 2022, 28 hearts and 12 pulmonary bifurcations were harvested at our institution and delivered to the European homograft bank. Twenty-seven valves (19 pulmonary valves, 8 aortic valves) were processed and allocated for implantation. The reasons for discarding a graft were either contamination (n = 14), or morphology (n = 13) or leaflet damage (n = 2). Five homografts (3 PV, 2 AV) have been cryopreserved and stored while awaiting allocation. One pulmonary homograft with a leaflet cut was retrieved by bicuspidization technique and awaits allocation, as a highly requested small diameter graft. The implementation of a tissue donation program in cooperation with a homograft bank can be achieved with reasonable additional efforts at a transplant center with an in-house cardiac surgery department. Challenging situations with a potential risk of tissue injury during procurement include re-operation, harvesting by a non-specialist surgeon and prior central cannulation for mechanical circulatory support. |
format | Online Article Text |
id | pubmed-10126547 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-101265472023-04-27 How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program Schmiady, Martin O. Jashari, Ramadan Lenherr, Renato Regenscheit, Stefan Hitendu, Dave Wendt, Martin Schiess, Stefanie Schweiger, Martin Hofmann, Michael Sromicki, Juri Flammer, Andreas Wilhelm, Markus J. Cesnjevar, Robert Carrel, Thierry Vogt, Paul R. Mestres, Carlos A. Cell Tissue Bank Full Length Paper Homograft heart valves may have significant advantages and are preferred for the repair of congenital valve malformations, especially in young women of childbearing age, athletes and in patients with active endocarditis. A growing problem, however, is the mismatch between tissue donation and the increasing demand. The aim of this paper is to describe the initiation process of a homograft procurement program to attenuate the shortage of organs. A comprehensive description of the infrastructure and procedural steps required to initiate a cardiac and vascular tissue donation program combined with a prospective follow-up of all homografts explanted at our institution. Between January 2020 and May 2022, 28 hearts and 12 pulmonary bifurcations were harvested at our institution and delivered to the European homograft bank. Twenty-seven valves (19 pulmonary valves, 8 aortic valves) were processed and allocated for implantation. The reasons for discarding a graft were either contamination (n = 14), or morphology (n = 13) or leaflet damage (n = 2). Five homografts (3 PV, 2 AV) have been cryopreserved and stored while awaiting allocation. One pulmonary homograft with a leaflet cut was retrieved by bicuspidization technique and awaits allocation, as a highly requested small diameter graft. The implementation of a tissue donation program in cooperation with a homograft bank can be achieved with reasonable additional efforts at a transplant center with an in-house cardiac surgery department. Challenging situations with a potential risk of tissue injury during procurement include re-operation, harvesting by a non-specialist surgeon and prior central cannulation for mechanical circulatory support. Springer Netherlands 2023-04-25 /pmc/articles/PMC10126547/ /pubmed/37097383 http://dx.doi.org/10.1007/s10561-023-10087-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Full Length Paper Schmiady, Martin O. Jashari, Ramadan Lenherr, Renato Regenscheit, Stefan Hitendu, Dave Wendt, Martin Schiess, Stefanie Schweiger, Martin Hofmann, Michael Sromicki, Juri Flammer, Andreas Wilhelm, Markus J. Cesnjevar, Robert Carrel, Thierry Vogt, Paul R. Mestres, Carlos A. How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program |
title | How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program |
title_full | How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program |
title_fullStr | How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program |
title_full_unstemmed | How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program |
title_short | How to counteract the lack of donor tissue in cardiac surgery? Initial experiences with a newly established homograft procurement program |
title_sort | how to counteract the lack of donor tissue in cardiac surgery? initial experiences with a newly established homograft procurement program |
topic | Full Length Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126547/ https://www.ncbi.nlm.nih.gov/pubmed/37097383 http://dx.doi.org/10.1007/s10561-023-10087-z |
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