Abstract:
:Heart transplantation remains the definitive management for end-stage heart failure refractory to medical therapy. While heart transplantation cases are increasing annually worldwide, there remains a deficiency in organ availability with significant patient mortality while on the waiting list. Attempts have therefore been made to expand the donor pool and improve access to available organs by recruiting donors who may not satisfy the standard criteria for organ donation because of donor pathology, anticipated organ ischemic time, or donation after circulatory death. "Ex vivo" heart perfusion (EVHP) is an emerging technique for the procurement of heart allografts. This technique provides mechanically supported warm circulation to a beating heart once removed from the donor and before implantation into the recipient. EVHP can be sustained for several hours, facilitate extended travel time, and enable administration of pharmacological agents to optimize cardiac recovery and function, as well as allow assessment of allograft function before implantation. In this article, we review recent advances in expanding the donor pool for cardiac transplantation. Current limitations of conventional donor criteria are outlined, including the determinants of organ suitability and assessment, involving transplantation of donation after circulatory death hearts, extended criteria donors, and EVHP-associated assessment, optimization, and transportation. Finally, ongoing research relating to organ optimization and functional ex vivo allograft assessment are reviewed.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Beuth J,Falter F,Pinto Ribeiro RV,Badiwala M,Meineri Mdoi
10.1213/ANE.0000000000003919subject
Has Abstractpub_date
2019-03-01 00:00:00pages
406-413issue
3eissn
0003-2999issn
1526-7598journal_volume
128pub_type
杂志文章,评审abstract:UNLABELLED:IV volume is often administered to patients in an intensive care unit (ICU) to improve cardiovascular function. We investigated the relationship between stroke volume (SV) and left ventricular (LV) size by using transesophageal echocardiography (TEE) in a population of 20 ICU patients and 21 postoperative ca...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200002000-00021
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:The bispectral index (BIS) monitor has been available for clinical use for >20 years and has had an immense impact on academic activity in Anesthesiology, with >3000 articles referencing the bispectral index. Despite attempts to infer its algorithms by external observation, its operation has nevertheless rem...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000005220
更新日期:2020-12-01 00:00:00
abstract:UNLABELLED:Perturbation of respiratory mechanics produced by general anesthesia and surgery is more pronounced in morbidly obese (MO) patients. Because general anesthesia induces pulmonary atelectasis in nonobese patients, we hypothesized that atelectasis formation would be particularly significant in MO patients. We i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200212000-00060
更新日期:2002-12-01 00:00:00
abstract::Changes in cardiac output in response to augmenting cardiac contractility, preload, and heart rate during enflurane anesthesia were examined in 12 open-chested dogs. Cardiac contractility was assessed by the slope of the end-systolic pressure-volume relation (Emax). Dobutamine (3, 6, and 9 micrograms.kg-1.min-1) was a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199111000-00014
更新日期:1991-11-01 00:00:00
abstract::Alfentanil, a short-acting lipophilic opioid, is used for labor analgesia and cesarean section and may cause neonatal depression. However, direct placental alfentanil transfer has not been studied. We measured placental alfentanil transfer and uptake during in vitro perfusion. Placenta lobules from healthy parturients...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199412000-00011
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Growing awareness of the negative impacts from the practice of health care on the environment and public health calls for the routine inclusion of life cycle criteria into the decision-making process of device selection. Here we present a life cycle assessment of 2 laryngeal mask airways (LMAs), a one-time-u...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31824f6959
更新日期:2012-05-01 00:00:00
abstract::Part I of this review discussed the similarities between embryogenesis, mammalian adaptions to hypoxia (primarily driven by hypoxia-inducible factor-1 [HIF-1]), ischemia-reperfusion injury (and its relationship with reactive oxygen species), hibernation, diving animals, cancer, and sepsis, and it focused on the common...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000001865
更新日期:2017-06-01 00:00:00
abstract::The intracranial and systemic hemodynamic effects of sufentanil (20 micrograms/kg) were studied in 10 mongrel dogs. Baseline anesthesia was maintained with 0.7% end-tidal isoflurane and 50% nitrous oxide in oxygen. Catheters were inserted for blood pressure measurement, arterial and sagittal sinus blood sampling, radi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199102000-00006
更新日期:1991-02-01 00:00:00
abstract::The choice between morphine and meperidine for postoperative pain is usually based on the preference of the prescriber, as few objective comparative data are available. This blind, randomized study compared the efficacy and side effects of morphine and meperidine administered by patient-controlled analgesia (PCA) for ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199704000-00018
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Increasing evidence links postoperative cognitive dysfunction (POCD) to surgery and anesthesia. POCD is recognized as an important neuropsychological adverse outcome in surgical patients, particularly the elderly. This prospective cohort study aimed to investigate whether POCD is associated with impaired int...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001803
更新日期:2017-03-01 00:00:00
abstract::Fifteen critically ill patients with acute respiratory failure were ventilated with high-frequency jet ventilation (HFJV; frequency 100 breaths/min; I/E ratio 0.43; 1.8-mm internal diameter injector cannula). The patients were divided into two groups according to their initial PaO2 during intermittent positive pressur...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-01-01 00:00:00
abstract::To determine whether concentrations of diethylaminoethanol (DEAE) and procaine below those that reduce the amplitude of action potentials might alter the excitability of brain cells, a single microelectrode intracellular recording technique was used to measure firing threshold and action potential amplitude of pyramid...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract::Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the contin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000002280
更新日期:2017-11-01 00:00:00
abstract::Prostaglandin E(2) receptors, subtype EP(1) (PGE(2)EP(1)) have been linked to several physiologic responses, such as fever, inflammation, and mechanical hyperalgesia. Local anesthetics modulate these responses, which may be due to direct interaction of local anesthetics with PGE(2)EP(1) receptor signaling. We sought t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200109000-00019
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:We hypothesized that, compared to remifentanil, dexmedetomidine used for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) performed under monitored anesthesia care (MAC) in nonintubated patients would result in fewer episodes of major respiratory adverse events (number of episodes...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000003633
更新日期:2019-01-01 00:00:00
abstract:UNLABELLED:We investigated the effect of epidural local anesthetic blockade on urinary substance P levels in five patients suffering from painful flare-ups of interstitial cystitis. Urine was collected in 24-h intervals commencing at the onset of an epidural bolus of 0.25% bupivacaine followed by maintenance epidural i...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000099362.01312.3a
更新日期:2004-03-01 00:00:00
abstract::The effectiveness of pulse wave monitoring of the big toes was compared with loss of cold discrimination to determine the onset of nerve blockade during lumbar epidural and spinal anesthesia. Forty-seven patients scheduled for elective urologic or lower extremity operations were assigned to one of three groups. Group ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Signal transduction cascade of anesthetic-induced preconditioning has been extensively studied, yet many aspects of it remain unsolved. Here, we investigated the roles of reactive oxygen species (ROS) and mitochondrial uncoupling in cardiomyocyte preconditioning by two modern volatile anesthetics: desflurane...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181a93ad9
更新日期:2009-08-01 00:00:00
abstract:UNLABELLED:We investigated the impact of cardiopulmonary bypass pump (CPB), hematocrit, gender, age, and body weight on blood use in patients undergoing coronary artery bypass graft surgery at a major university hospital. Participants were 1235 consecutive patients undergoing primary coronary artery surgery over a peri...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000081790.75298.d8
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:We previously reported that the duration of hospitalization was not different between isoflurane and sevoflurane. But more plausible consequences of using soluble volatile anesthetics are delayed emergence from anesthesia and prolonged stays in the postanesthesia care unit (PACU). We therefore compared isofl...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000004093
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Lidocaine is used clinically for tactile allodynia associated with diabetes-induced neuropathy. Although the analgesic effect of lidocaine through suppression of microglial activation has been implicated in the development of injury-induced neuropathic pain, its mechanism of action in diabetes-induced tactil...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31822827a2
更新日期:2011-10-01 00:00:00
abstract:UNLABELLED:Ketamine, a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, has psychotomimetic activity. NMDA receptor antagonists cause morphological damage in the posterior cingulate cortex, which may be the brain region responsible for their psychotomimetic effects. Benzodiazepines are effective in preve...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199812000-00040
更新日期:1998-12-01 00:00:00
abstract::A study was undertaken in 15 patients to compare measured and assumed arteriovenous oxygen (A-V O2) content differences and their effects on resultant shunt calculations. All patients were on volume ventilators and demonstrated a stable cardiovascular state. Simultaneous measurements of the O2 content of a pulmonary a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197503000-00008
更新日期:1975-03-01 00:00:00
abstract::In this prospective, randomized, double-blind study, we compared the efficacy and safety of ondansetron and metoclopramide in the treatment of postoperative nausea and vomiting (PONV). One hundred seventy-five patients with PONV during recovery from anesthesia for gynecological laparoscopy were treated intravenously w...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199708000-00027
更新日期:1997-08-01 00:00:00
abstract::Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraop...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000001485
更新日期:2016-11-01 00:00:00
abstract::Lidocaine and MgSO4 are often coadministered to patients with pregnancy-induced hypertension. This study examined whether MgSO4 alters the lidocaine-seizure threshold in the rat and, if so, whether systemic MgSO4 administration is as effective as intracerebroventricular MgSO4 infusion. In Experiment 1, rats were admin...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199612000-00016
更新日期:1996-12-01 00:00:00
abstract::We investigated the effects of a close carotid injection of vecuronium on changes in phrenic nerve activity during different states of oxygenation. Experiments were performed on normothermic and mechanically ventilated adult New Zealand White rabbits with a tracheostomy under continuous thiopental infusion. Carotid ar...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199606000-00026
更新日期:1996-06-01 00:00:00
abstract::The value of family-centered care in general and subspecialty pediatrics has been well documented in the literature. Translation of these principles into perioperative medicine has its logistical challenges; however, there are theoretical benefits. Specifically, pediatric patients with psychiatric diagnoses or special...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31827ab89c
更新日期:2013-06-01 00:00:00
abstract::Myocardial injury after noncardiac surgery (MINS) differs from myocardial infarction in being defined by troponin elevation apparently from cardiac ischemia with or without signs and symptoms. Such myocardial injury is common, silent, and strongly associated with mortality. MINS is usually asymptomatic and only detect...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000004567
更新日期:2020-07-01 00:00:00
abstract::In this prospective, randomized, placebo-controlled, double-blind trial we studied the effects of IV N-acetylcysteine for prevention of renal injury in patients undergoing abdominal aortic surgery. Seventy patients without previously documented renal dysfunction were randomly allocated to receive either N-acetylcystei...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ANE.0000219590.79796.66
更新日期:2006-06-01 00:00:00