nrp-heart
title

Normothermic regional perfusion for heart transplantation from controlled donation after circulatory death

Eligibilityinclusion · exclusion
include · 8
Population undergoing heart transplantation
Study evaluates at least one of: normothermic regional perfusion, thoracoabdominal NRP (TA-NRP), or abdominal NRP (A-NRP)
Comparator is at least one of: controlled DCD without NRP followed by static cold storage, controlled DCD without NRP followed by ex-situ machine perfusion, or donation after brain death (DBD)
Controlled DCD donors when DCD organs are used (Maastricht category III or IV)
Randomized controlled trials or non-randomized comparative studies
Heart-recipient outcomes reported separately when multi-organ donors are included
Published in English
Primary research published in peer-reviewed journals
exclude · 10
Uncontrolled donation after circulatory death (Maastricht categories I and II)
Multi-organ studies without separately reported heart transplant recipient outcomes
Case reports
Editorials
Commentaries
Letters
Narrative reviews
Conference abstracts
Conference posters
Animal studies
Search strategy3 groups (AND across, OR within)
group 1 · 8 terms (OR)
heart transplantationheart transplantcardiac transplantationcardiac transplantorthotopic heart transplantationorthotopic heart transplantOHTheart allograft
and
group 2 · 14 terms (OR)
donation after circulatory deathdonation after cardiac deathdonation after circulatory determination of deathDCDcDCDcontrolled DCDcontrolled donation after circulatory deathMaastricht category IIIMaastricht IIIdonation after brain deathDBDbrain dead donordonation after neurologic determination of deathDNDD
and
group 3 · 16 terms (OR)
normothermic regional perfusionNRPTA-NRPthoracoabdominal normothermic regional perfusionthoracoabdominal NRPA-NRPabdominal normothermic regional perfusionabdominal NRPin situ perfusiondirect procurement and perfusionDPPex situ machine perfusionex-situ machine perfusionstatic cold storageOrgan Care SystemOCS
Axis
identification

Locate the arms in methods descriptions of donor type and procurement/perfusion technique, randomization tables when present, or table column headers contrasting NRP, non-NRP static cold storage, non-NRP machine perfusion, and DBD groups. Dimension (categorical) — the donor recovery and preservation strategy used for the transplanted heart.

arm · nrp

Controlled DCD heart recovery with in-situ normothermic regional perfusion (thoracoabdominal TA-NRP or abdominal-only A-NRP), with or without subsequent static cold storage or ex-situ machine perfusion, including 'NRP', 'TA-NRP', 'A-NRP', 'thoracoabdominal NRP', 'abdominal NRP', and 'in situ normothermic regional perfusion'.

arm · scs

Controlled DCD heart recovery without NRP (direct procurement) followed by static cold storage only, including 'direct procurement + SCS', 'static cold storage', 'cold/ice storage without NRP', 'DCD-SCS', and 'direct procurement without machine perfusion'.

arm · mp

Controlled DCD heart recovery without preceding in-situ NRP (direct procurement) followed by ex-situ machine perfusion (hypothermic or normothermic), including 'DPP', 'direct procurement and perfusion', 'Organ Care System (OCS)', 'ex-situ machine perfusion', and 'machine perfusion after direct procurement'.

arm · dnc

Donation after neurological death (brain death) donors with any preservation method, including 'DBD', 'DNC', 'DNDD', 'donation after brain death', 'brain-dead donors', and 'neurologic determination of death'.

Outcomes5 primary · 12 secondary
primary · 5
recipient_survivalRecipient survival at 1, 6, and 12 months after heart transplantation.
graft_survivalCardiac graft survival at 1, 6, and 12 months after transplantation.
primary_graft_dysfunctionPrimary graft dysfunction defined according to ISHLT criteria.
early_allograft_dysfunctionEarly cardiac allograft dysfunction after transplantation.
primary_nonfunctionPrimary nonfunction of the cardiac allograft.
secondary · 12
acute_rejectionAcute cellular rejection of the cardiac allograft.
antibody_mediated_rejectionAntibody-mediated rejection of the cardiac allograft.
cardiac_allograft_vasculopathyCardiac allograft vasculopathy after transplantation.
mechanical_circulatory_supportPost-transplant mechanical circulatory support including IABP, ECMO, and VAD.
hospital_length_of_stayLength of hospital stay after transplantation.
icu_length_of_stayLength of intensive care unit stay after transplantation.
ventilation_durationDuration of mechanical ventilation after transplantation.
retransplantationNeed for cardiac retransplantation.
acute_kidney_injuryAcute kidney injury or new renal replacement therapy after transplantation.
strokeStroke or other major neurologic complication after transplantation.
reexploration_for_bleedingSurgical reexploration for bleeding after transplantation.
infectionClinically significant post-transplant infection.