RETRACTED ARTICLE: History of heart transplantation, the resurgence of DCD heart donations and outcomes following transp
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REVIEW ARTICLE
History of heart transplantation, the resurgence of DCD heart donations and outcomes following transplantation; the Royal Papworth Experience Catherine Dushyanthy Sudarshan 1 Received: 9 March 2020 / Revised: 24 April 2020 / Accepted: 1 May 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020
Abstract Human heart transplantation started more than half a century ago. The Royal Papworth Hospital, in Cambridgeshire, United Kingdom, where this procedure has been performed for more than four decades, has pioneered the resurgence of Donor Circulatory Death (DCD) heart transplantation, acknowledging the fact that the first transplant performed by Dr. Christian Barnard was from a DCD donor. The history of this procedure, the work carried out towards establishing a robust and successful DCD heart transplant program and the outcomes of the first fifty DCD heart transplants are described and discussed. Keywords Heart transplantation . Donation after circulatory death . Organ care systems
Introduction Despite major advances in the treatment of end-stage drugresistant heart failure, including ventricular assist devices [1], total artificial hearts [2] and stem cell therapy [3], there remains no intervention equivalent to heart transplantation, offering comparable long-term survival or quality of life. Over the last 50 years, more than 120,000 heart failure patients worldwide have benefited from this gold standard treatment option, extending life by an average of 11.9 years [4]. Unfortunately, the incidence of heart failure continues to rise despite already being the leading cause of death in the Western world [5]. In the United States of America (USA), 5.1 million people live with heart failure with an additional 825,000 patients diagnosed annually [6]. With an ageing population, the incidence of heart failure is set to increase by 46% in the USA over the next 20 years with economic costs expected to reach 70 billion dollars [7]. Of the 12,300 patients in the USA who are eligible for either a heart transplant or ventricular assist device last year, only 2531 heart transplants were performed due to a shortage of suitable donor organs. * Catherine Dushyanthy Sudarshan [email protected] 1
Department of Cardiothoracic Surgery and Transplantation, Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, UK
In the United Kingdom (UK), of some 750,000 patients diagnosed with heart failure, only 181 patients received a heart transplant in 2015 [8]. The demand for heart transplantation within the UK has been increasing rapidly with a threefold increase in the heart transplant waiting list over the last 10years (Fig. 1). The rapid increase in demand for heart transplantation is also mirrored throughout Europe (Fig. 2). (Annual report on cardiothoracic activity, last accessed on 21st April 2018, available at https://nhsbtdbe.blob.core. windows.net/umbraco-assets-corp/5418/cardiothoracicannual-report- 2016-17.pdf) (Annual report 2016, accessed on 21st April 2018, available at https://www.
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