Ex Vivo Organ Perfusion for Heart Procurement in High-Risk Transplantations: A Multicenter Study

Rojas, Sebastián V.; Ius, F.; Schibilsky, David; Kaufeld, Tim; Benk, Christoph; Sommer, W.; Goecke, Tobias; Avşar, M.; Poyanmehr, Reza; Rümke, S.; Mogaldea, A.; Bobylev, D.; Salman, J.; Siemeni, T.; Bara, Christoph; Beyersdorf, Friedhelm; Haverich, Axel; Siepe, Matthias; Warnecke, G.

doi:10.1016/j.healun.2020.01.1044

Cited by 1 publication

(4 citation statements)

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“…One additional study was identified from the screening of reference lists in the included publications. Ultimately, 40 studies were included in this review: 18 papers ( 6 , 7 , 9 - 24 ), 17 conference abstracts ( 5 , 25 – 40 ), and five ongoing clinical trials ( 41 - 45 ). Three studies reported multicenter data ( 7 , 25 , 40 ), and three were randomized controlled studies ( 7 , 12 , 13 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one publications, including eight papers ( 7 , 10 , 12 – 16 , 21 ) and 13 conference abstracts ( 5 , 25 – 35 , 40 ) presented results from using the OCS at transplantation of DBD hearts with or without a control group ( Tables 2 , 3 ). Three of these studies were randomized ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies ( 5 , 14 , 16 , 21 , 25 , 26 , 29 – 33 , 35 , 40 ) used the OCS in high-risk cases. High risk was defined as an adverse donor/recipient profile, including an estimated ischemic time longer than 4 h, left ventricular ejection fraction less than 50%, left ventricular hypertrophy, donor cardiac arrest, alcohol/drug abuse, coronary artery disease, recipient mechanical circulatory support, and/or elevated pulmonary vascular resistance.…”

Section: Resultsmentioning

confidence: 99%

“…Although both patients remained well at 6 months with normal cardiac function, the patient who received the SCS-preserved heart had a longer hospital stay (50 vs. 12 days) and a higher cost (AU$ 234,160 vs. 56,658) compared with the OCS recipient ( 14 ). In nine publications, only the OCS was studied ( Table 3 ) ( 5 , 10 , 16 , 21 , 32 – 35 , 40 ). In general, the OCS preserved heart function well, resulting in a satisfactory postoperative survival rate for the recipients.…”

Section: Resultsmentioning

confidence: 99%

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Machine Perfusion for Human Heart Preservation: A Systematic Review

et al. 2022

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Currently, static cold storage (SCS) of hearts from donations after brainstem death remains the standard clinically. However, machine perfusion (MP) is considered an approach for donor organ management to extend the donor pool and/or increase the utilization rate. This review summarizes and critically assesses the available clinical data on MP in heart transplantation. We searched Medline (PubMed), Cochrane, Embase, and clinicaltrials.gov, along with reference lists of the included publications and identified 40 publications, including 18 articles, 17 conference abstracts, and five ongoing clinical trials. Two types of MP were used: hypothermic MP (HMP) and normothermic MP (NMP). Three studies evaluated HMP, and 32 evaluated NMP. Independent of the system, MP resulted in clinical outcomes comparable to traditional SCS. However, NMP seemed especially beneficial for high-risk cases and donation after circulatory death (DCD) hearts. Based on currently available data, MP is non-inferior to standard SCS. Additionally, single-centre studies suggest that NMP could preserve the hearts from donors outside standard acceptability criteria and DCD hearts with comparable results to SCS. Finally, HMP is theoretically safer and simpler to use than NMP. If a machine malfunction or user error occurs, NMP, which perfuses a beating heart, would have a narrower margin of safety. However, further well-designed studies need to be conducted to draw clear conclusions.

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