A Perioperative Blood Conservation Protocol to Achieve Successful Bloodless Heart Transplantation
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.
Authors
- David A. D’Alessandro (ORCID: https://orcid.org/0000-0001-9693-7313)
- Kemar Brown (ORCID: https://orcid.org/0000-0002-2184-4654)
- Van‐Khue Ton (ORCID: https://orcid.org/0000-0001-8287-2571)
- Christopher Newton‐Cheh (ORCID: https://orcid.org/0000-0002-3001-9111)
- Andrew S. Oseran (ORCID: https://orcid.org/0000-0002-5810-5927)
- Tanvir Kahlon
- Jordan D. Secor
- Jerome Crowley (ORCID: https://orcid.org/0000-0001-8833-8281)
- Ioannis Mastoris (ORCID: https://orcid.org/0000-0002-1779-6629)
- Antonia Kreso (ORCID: https://orcid.org/0000-0003-0632-958X)
- Gregory D. Lewis (ORCID: https://orcid.org/0000-0001-8108-8240)
- William D. Carlson
- Guilherme Nasi (ORCID: https://orcid.org/0000-0002-0785-6704)
- Meaghan Doucette
- Erin Coglianese (ORCID: https://orcid.org/0000-0002-8144-9031)
- Charounipha Soydara
- Kristian Bakken
- Megan Kramer
- Daniel A. Zlotoff (ORCID: https://orcid.org/0000-0001-9007-7295)
- Eriberto Michel (ORCID: https://orcid.org/0000-0002-1883-4092)
- R. M. A. McClelland
- Frederick Lang (ORCID: https://orcid.org/0000-0001-8866-4490)
- Bin Yang (ORCID: https://orcid.org/0000-0002-9653-145X)
- Lana Tsao
- Esther Shao
- Julia Allen
- Vlada Usherenko
Institutions
- Massachusetts General Hospital (US)
Publication Details
- Journal
- ASAIO Journal
- Published
- 2025-12-09
- DOI
- https://doi.org/10.1097/mat.0000000000002626
- Primary Topic
- Transplantation: Methods and Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 0.00