Heart failure & cardiomyopathies
Increasing Utilization of Extended Criteria Donor Hearts for Transplantation: The OCS Heart EXPAND Trial
Authors' conclusion
Use of an extracorporeal perfusion system resulted in successfully transplanting 87% of donor hearts with excellent patient survival to 2 years post-transplant and low rates of severe PGD.
Study context
- Population
- Adult heart transplant recipients receiving extended criteria donor (ECD) hearts from donation after brain death (DBD)ECD DBD hearts perfused
- Participants
- 173 recipients
- Outcome
- Composite of 30-day survival and absence of severe primary graft dysfunction (PGD)
- Follow-up
- 30 days
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
30-day survival free of severe PGD
Survived with no severe primary graft dysfunction (PGD) at 30 days
92%
Observational data: associations, not effects.
Secondary outcomes
Donor heart utilization rate
- Perfused ECD DBD hearts successfully transplanted
- 150 (87%)
- Did not meet study transplantation criteria
- 23 (13%)
30-day survival
- 30-day survival
- 97%
Severe PGD
- Incidence of severe PGD
- 6.7%
Patient survival through 2 years · 6, 12 and 24 months
- Survival at 6 months
- 93%
- Survival at 12 months
- 89%
- Survival at 24 months
- 86%
- Comparable with concurrent nonrandomized controls
Safety
Heart graft-related serious adverse events within 30 days
- Mean number of heart graft-related serious adverse events
- 0.17 (95% CI: 0.11-0.23)
Original publication
Increasing Utilization of Extended Criteria Donor Hearts for Transplantation: The OCS Heart EXPAND Trial. JACC Heart Fail. Published 24 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it