This publication reports an unplanned post hoc analysis of a multicenter, prospective, nonrandomized trial (NOVEL / NOVEL Extension) that took place in the US during 2011 to 2017 with 3 years of follow-up. Patients were placed into 3 groups based on procurement strategy: brain-dead donor (control) (n=115), brain-dead donor evaluated by EVLP (n=82), and DCD donors evaluated by EVLP (n=28).
Recipients who received DCD EVLP allografts had significantly higher incidence of severe primary graft dysfunction at 72 hours, longer days on mechanical ventilation and in-hospital length of stay. However, 3-year survival was not statistically significant between the groups. Also, bronchiolitis obliterans syndrome and quality of life metrics did not differ significantly among the groups at 3-year follow-up.
The authors conclude that whereas DCD EVLP allografts might not be appropriate to transplant in every candidate recipient, the expansion of their use might afford recipients stagnant on the waitlist a viable therapy.
J Thorac Cardiovasc Surg, / 2024 / doi: 10.1016/j.jtcvs.2024.03.011
