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34


Donation After Circulatory Death Heart Transplants: Doing More and Waiting Less [Editorial]

Ngai, Jennie; Jankowska, Anna
PMID: 37743133
ISSN: 1532-8422
CID: 5609522

Intraoperative Considerations and Management of Simultaneous Heart Kidney Transplantation

Ngai, Jennie; Keny, Nikhil; James, Les; Katz, Simon; Moazami, Nader
PMID: 37210325
ISSN: 1532-8422
CID: 5508212

I, Robot: Healthcare Decisions Made With Artificial Intelligence [Editorial]

Jankowska, Anna; Ngai, Jennie
PMID: 37500370
ISSN: 1532-8422
CID: 5593852

Are Ventricular Assist Devices Leading the Way in Patients With Advanced Heart Failure? [Editorial]

Desai, Krupa; Ngai, Jennie
PMID: 37120326
ISSN: 1532-8422
CID: 5465792

Pig-to-human heart xenotransplantation in two recently deceased human recipients

Moazami, Nader; Stern, Jeffrey M; Khalil, Karen; Kim, Jacqueline I; Narula, Navneet; Mangiola, Massimo; Weldon, Elaina P; Kagermazova, Larisa; James, Les; Lawson, Nikki; Piper, Greta L; Sommer, Philip M; Reyentovich, Alex; Bamira, Daniel; Saraon, Tajinderpal; Kadosh, Bernard S; DiVita, Michael; Goldberg, Randal I; Hussain, Syed T; Chan, Justin; Ngai, Jennie; Jan, Thomas; Ali, Nicole M; Tatapudi, Vasishta S; Segev, Dorry L; Bisen, Shivani; Jaffe, Ian S; Piegari, Benjamin; Kowalski, Haley; Kokkinaki, Maria; Monahan, Jeffrey; Sorrells, Lori; Burdorf, Lars; Boeke, Jef D; Pass, Harvey; Goparaju, Chandra; Keating, Brendan; Ayares, David; Lorber, Marc; Griesemer, Adam; Mehta, Sapna A; Smith, Deane E; Montgomery, Robert A
Genetically modified xenografts are one of the most promising solutions to the discrepancy between the numbers of available human organs for transplantation and potential recipients. To date, a porcine heart has been implanted into only one human recipient. Here, using 10-gene-edited pigs, we transplanted porcine hearts into two brain-dead human recipients and monitored xenograft function, hemodynamics and systemic responses over the course of 66 hours. Although both xenografts demonstrated excellent cardiac function immediately after transplantation and continued to function for the duration of the study, cardiac function declined postoperatively in one case, attributed to a size mismatch between the donor pig and the recipient. For both hearts, we confirmed transgene expression and found no evidence of cellular or antibody-mediated rejection, as assessed using histology, flow cytometry and a cytotoxic crossmatch assay. Moreover, we found no evidence of zoonotic transmission from the donor pigs to the human recipients. While substantial additional work will be needed to advance this technology to human trials, these results indicate that pig-to-human heart xenotransplantation can be performed successfully without hyperacute rejection or zoonosis.
PMID: 37488288
ISSN: 1546-170x
CID: 5595152

A Call for Diversity: Women, Professional Development, and Work Experience in Cardiothoracic Anesthesiology

Ngai, Jennie; Capdeville, Michelle; Sumler, Michele; Oakes, Daryl
PMID: 36599777
ISSN: 1532-8422
CID: 5410012

Donation after circulatory death heart transplantation using normothermic regional perfusion:The NYU Protocol

James, Les; LaSala, V Reed; Hill, Fredrick; Ngai, Jennie Y; Reyentovich, Alex; Hussain, Syed T; Gidea, Claudia; Piper, Greta L; Galloway, Aubrey C; Smith, Deane E; Moazami, Nader
OBJECTIVE/UNASSIGNED:This study aimed to evaluate the impact of cardiopulmonary bypass for thoraco-abdominal normothermic regional perfusion on the metabolic milieu of donation after cardiac death organ donors before transplantation. METHODS/UNASSIGNED:Local donation after cardiac death donor offers are assessed for suitability and willingness to participate. Withdrawal of life-sustaining therapy is performed in the operating room. After declaration of circulatory death and a 5-minute observation period, the cardiac team performs a median sternotomy, ligation of the aortic arch vessels, and initiation of thoraco-abdominal normothermic regional perfusion via central cardiopulmonary bypass at 37 °C. Three sodium chloride zero balance ultrafiltration bags containing 50 mEq sodium bicarbonate and 0.5 g calcium carbonate are infused. Arterial blood gas measurements are obtained every 15 minutes after every zero balance ultrafiltration bag is infused, and blood is transfused as needed to maintain hemoglobin greater than 8 mg/dL. Cardiopulmonary bypass is weaned with concurrent hemodynamic and transesophageal echocardiogram evaluation of the donor heart. The remainder of the procurement, including the abdominal organs, proceeds in a similar controlled fashion as is performed for a standard donation after brain death donor. RESULTS/UNASSIGNED:.001) . On average, donation after cardiac death donors received transfusions of 2.3 ± 1.5 units of packed red blood cells. Of the 18 donors who underwent normothermic regional perfusion, all hearts were deemed suitable for recovery and successfully transplanted, a yield of 100%. Other organs successfully recovered and transplanted include kidneys (80.6% yield), livers (66.7% yield), and bilateral lungs (27.8% yield). CONCLUSIONS/UNASSIGNED:The use of cardiopulmonary bypass for thoraco-abdominal normothermic regional perfusion is a burgeoning option for improving the quality of organs from donation after cardiac death donors. Meticulous intraoperative management of donation after cardiac death donors with a specific focus on improving their metabolic milieu may lead to improved graft function in transplant recipients.
PMCID:9938390
PMID: 36820336
ISSN: 2666-2507
CID: 5509582

Donation After Circulatory Death: Expanding Heart Transplants

Koscik, Rebecca; Ngai, Jennie
Heart failure affects 6.2 million adults in the United States (US), resulting in a decrease in quality of life. Limited options exist for the treatment of end-stage heart failure. Mechanical circulatory support and transplantation are considered when no further optimization can be obtained with medical management. Heart transplant is regarded as superior to mechanical assist devices due to a lower incidence of multiorgan dysfunction. However, transplants are limited by the availability of donor organs. Heart transplants using organs from donation after circulatory death (DCD) have blossomed globally since 2014; whereas, in the US, this method has had a slower implementation. Today, the realization of the need to increase the number of donor hearts has reinvigorated the interest in heart transplantation using DCD organs. The authors review the process and discuss the unique opportunities anesthesiologists have to impact the future success of DCD heart transplantation as it continues to expand.
PMID: 35831232
ISSN: 1532-8422
CID: 5269282

Results of Heart Transplants from Donation After Circulatory Death (DCD) Donors Using Thoraco-Abdominal Normothermic Regional Perfusion (TA-NRP) Compared to Donation After Brain Death ( [Meeting Abstract]

Gidea, C G; James, L; Smith, D; Carillo, J; Reyentovich, A; Saraon, T; Rao, S; Goldberg, R; Kadosh, B; Ngai, J; Piper, G; Narula, N; Moazami, N
Purpose: In the U.S., heart transplantation from donation after circulatory death (DCD) is increasing. We present our institutional experience of DCD transplantation by using a thoracoabdominal-normothermic regional perfusion (TA-NRP) protocol and compare the results to a cohort concomitantly transplanted, from standard brain death (
EMBASE:2017591137
ISSN: 1557-3117
CID: 5240352

Preoperative Care Practice for Female Cardiac Patients: A Survey From the Society of Cardiovascular Anesthesiologists [Letter]

Nanegrungsunk, Danop; Patel, Shayna; Jan, Thomas; Ngai, Jennie Y
PMID: 34776353
ISSN: 1532-8422
CID: 5048912