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1024. Mitochondrial Donation and Preimplantation Genetic Testing for mtDNA Disease.
作者: Louise A Hyslop.;Emma L Blakely.;Magomet Aushev.;Jordan Marley.;Yuko Takeda.;Angela Pyle.;Eilis Moody.;Catherine Feeney.;Jan Dutton.;Carol Shaw.;Sarah J Smith.;Kate Craig.;Charlotte L Alston.;Lisa Lister.;Karina Endacott.;Samantha Byerley.;Helen McDermott.;Kathryn Wilson.;Lynne Botham.;Beth Matthew.;Nilendran Prathalingam.;Matthew Prior.;Alison Murdoch.;Douglass M Turnbull.;Gavin Hudson.;Meenakshi Choudhary.;Robert W Taylor.;Rekha N Pillai.;Jane A Stewart.;Robert McFarland.;Mary Herbert.
来源: N Engl J Med. 2025年393卷5期438-449页
Children born to women who carry pathogenic variants in mitochondrial DNA (mtDNA) are at risk for a range of clinical syndromes collectively known as mtDNA disease. Mitochondrial donation by pronuclear transfer involves transplantation of nuclear genome from a fertilized egg from the affected woman to an enucleated fertilized egg donated by an unaffected woman. Thus, pronuclear transfer offers affected women the potential to have a genetically related child with a reduced risk of mtDNA disease.
1031. Monoclonal Anti-Platelet Factor 4 Antibodies in Recurrent Pregnancy Loss.
作者: Natalie R Bavli.;Adam J Kanack.;Yoshito Nishimura.;Noah P Splinter.;Emily E Mauch.;Alessandra J Ainsworth.;Ravi Sarode.;Robert D McBane.;Mindy C Kohlhagen.;David Murray.;Dong Chen.;Rajiv K Pruthi.;Anand Padmanabhan.
来源: N Engl J Med. 2025年393卷3期306-309页 1036. On-Table Reanimation of a Pediatric Heart from Donation after Circulatory Death.
Cardiac allotransplantation is warranted in children with end-stage heart failure or irreparable congenital heart disease. A dearth of organs for transplantation has contributed to long wait-list times and resultant deaths in this population. Donation after circulatory death (DCD) with normothermic regional perfusion has the potential to increase the donor pool by up to 30%. Ethical concerns have limited adoption of this technique in the United States and abroad. Consequently, a method facilitating ex vivo resuscitation of hearts from deceased donors after circulatory death (i.e., DCD hearts) is needed. We describe an on-table reanimation of a pediatric DCD heart transplanted into a 3-month-old recipient. Adverse events are reported.
1037. Rapid Recovery of Donor Hearts for Transplantation after Circulatory Death.
作者: Aaron M Williams.;John M Trahanas.;Swaroop Bommareddi.;Brian Lima.;Stephen A DeVries.;Joshua Lowman.;Awab Ahmad.;Eric Quintana.;Shelley R Scholl.;Stacy Tsai.;Dawn Pedrotty.;Matthew Warhoover.;Harry Moneypenny.;Stephen Tapia-Ruano.;Matthew Bacchetta.;Kelly Schlendorf.;Ashish S Shah.
来源: N Engl J Med. 2025年393卷3期267-274页
We report a method for the recovery of hearts for transplantation from deceased donors after circulatory death that obviates the need for thoracoabdominal normothermic regional perfusion or ex situ perfusion systems. After death, the aorta is clamped and a flush circuit is established to perform a controlled, extended, ultraoxygenated flush of the donor heart at a mean aortic-root pressure of 80 mm Hg. In the first three reported cases in which this method was used, the hearts were transplanted successfully with normal biventricular function, no evidence of acute cellular or antibody-mediated rejection, and excellent early postoperative outcomes. No adverse events were reported during the perioperative period. By avoiding the limitations of ex situ perfusion platforms as well as the controversial aspects of thoracoabdominal normothermic regional perfusion, this method of heart recovery offers the possibility of broad application.
1038. Multidose Ondansetron after Emergency Visits in Children with Gastroenteritis.
作者: Stephen B Freedman.;Sarah Williamson-Urquhart.;Amy C Plint.;Andrew Dixon.;Darcy Beer.;Gary Joubert.;Petros Pechlivanoglou.;Yaron Finkelstein.;Anna Heath.;Jasper Zhongyuan Zhang.;Angela Wallace.;Martin Offringa.;Terry P Klassen.; .
来源: N Engl J Med. 2025年393卷3期255-266页
Ondansetron improves outcomes when administered in emergency departments to children with acute gastroenteritis-associated vomiting. It is commonly prescribed at discharge to reduce symptoms, but evidence to support this practice is limited.
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