ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2025
A Perioperative Blood Conservation Protocol to Achieve Successful Bloodless Heart Transplantation.
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Lang Frederick M, Nasi Guilherme Marmontel, Allen Julia, Bakken Kristian, Brown Kemar J, Carlson William, Coglianese Erin, Doucette Meaghan, Kahlon Tanvir, Kramer Megan, Mastoris Ioannis, McClelland Rebecca, Newton-Cheh Christopher, Oseran Andrew S, Shao Esther, Soydara Charounipha, Ton Van-Khue T, Tsao Lana, Usherenko Vlada, Yang Bin Q, Crowley Jerome, Michel Eriberto, Secor Jordan D, Kreso Antonia, Lewis Gregory D, D'Alessandro David A, Zlotoff Daniel A
Аннотация
Heart transplantation (HT) is the definitive therapy for end-stage heart failure. Patients unwilling to receive blood product transfusions are often considered ineligible for HT due to the significant perioperative bleeding risk. "Bloodless" HT-that is, without use of blood product transfusions-provides the opportunity to extend this critical intervention to such patients. Here we describe our center's peri-transplant blood conservation protocol that supported successful bloodless HT in two patients unwilling to receive blood product transfusions. One of these patients represents the first described case of temporary mechanical circulatory support as a bridge to bloodless HT, which is of particular importance given the increasing use of such support before HT more broadly. Clinical management decisions and interventions that decreased blood loss, minimized bleeding risk, and stimulated erythropoiesis are highlighted. Utilization of similar strategies may allow for expansion of bloodless HT to centers that have previously not offered this therapy.