Presenter Biography
Saifullah Hasan is a second year medical student at the Oregon Health and Science University.
Institution
OHSU
Program/Major
School of Medicine
Degree
MD
Presentation Type
Poster
Room Location
Smith Memorial Student Union, Room 296/8
Start Date
April 2019
End Date
April 2019
Persistent Identifier
https://archives.pdx.edu/ds/psu/30966
Abstract
Donation after circulatory death (DCD) is a potential avenue to narrow the gap between demand for donor hearts and their limited supply. DCD was abandoned after 1970 where donation of organs after brain death became the standard, however DCD has made a recent resurgence for organ donation, predominantly for lung transplants which has shown much success. Heart transplant donors primarily source from brain dead donors. Benefits of DCD for heart transplants include an expanded donor pool to address the drastic shortage of supply and reduced onerous financial burden. Drawbacks of heart DCD include substantial ischemia reperfusion injury (IRI) and inflammation experienced by the donor heart. IRI changes the metabolic phenotype of the myocardium, compromising its efficiency. Pharmacological interventions by manipulating metabolic signaling pathways can shift the myocardium towards cardioprotective phenotypes to maximize the integrity of the organ during the stressful transplantation process. Lastly, a process of ischemic pre and post conditioning of the heart tissue to facilitate an incremental adjustment to ischemic conditions as a therapeutic approach is desirable. We review the practicality of DCD along with the financial and logistical constraints of implementing this technology, including the optimization of signaling pathways and conditioning strategies to reduce IRI in heart transplant.
Included in
Heart Transplant: Donation after Circulatory Death
Smith Memorial Student Union, Room 296/8
Donation after circulatory death (DCD) is a potential avenue to narrow the gap between demand for donor hearts and their limited supply. DCD was abandoned after 1970 where donation of organs after brain death became the standard, however DCD has made a recent resurgence for organ donation, predominantly for lung transplants which has shown much success. Heart transplant donors primarily source from brain dead donors. Benefits of DCD for heart transplants include an expanded donor pool to address the drastic shortage of supply and reduced onerous financial burden. Drawbacks of heart DCD include substantial ischemia reperfusion injury (IRI) and inflammation experienced by the donor heart. IRI changes the metabolic phenotype of the myocardium, compromising its efficiency. Pharmacological interventions by manipulating metabolic signaling pathways can shift the myocardium towards cardioprotective phenotypes to maximize the integrity of the organ during the stressful transplantation process. Lastly, a process of ischemic pre and post conditioning of the heart tissue to facilitate an incremental adjustment to ischemic conditions as a therapeutic approach is desirable. We review the practicality of DCD along with the financial and logistical constraints of implementing this technology, including the optimization of signaling pathways and conditioning strategies to reduce IRI in heart transplant.