Heart failure & cardiomyopathies

Early U.S. Heart Transplant Experience With Normothermic Regional Perfusion Following Donation After Circulatory Death

JACC Heart FailPublished Retrospective cohort study

Main finding · Overall survivalResult — go to the resultHazard ratio 0.39 95% CI 0.22–0.70

Authors' conclusion

In this largest national series of DCD HT procurement perfusion strategies, NRP is associated with improved short-term survival as compared with DPP.

Study context

Population
Adult recipients and donors of controlled DCD heart transplantation, UNOS registry, January 2019-December 2023
Participants
918 recipients
Exposure
Normothermic regional perfusion (NRP) vs direct procurement and perfusion (DPP) procurement in DCD heart transplantation
  • NRPn = 296
  • DPPn = 622reference
Outcome
Overall survival
Methodological detailsnational registry (UNOS), propensity-matched analysis
  • National registry (UNOS)
  • Propensity-matched analysis

Main finding

Overall survival

Hazard ratio

0.39

95% CI 0.22–0.70

P = 0.002

NRP vs DPP
HR 0.39 (95% CI 0.22–0.70); P = 0.002

As reported in the abstract

Unadjusted Kaplan-Meier: improved short-term survival with NRP
log-rank P = 0.005
Propensity-matched analysis: cumulative survival benefit to NRP
log-rank P = 0.006

Observational data: associations, not effects.

Original publication

Early U.S. Heart Transplant Experience With Normothermic Regional Perfusion Following Donation After Circulatory Death. JACC Heart Fail. Published 31 July 2024. doi:10.1016/j.jchf.2024.06.007

Summarised from the published abstract; every number is checked against it

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