Austrian Analysis of the GUARDIAN Registry: Heart Transplant Effects in Europe from the Global Pandemic

Moayedifar, R.; Angleitner, Philipp; Gökler, Johannes; Osorio, Emilio; Horvat, Johann; Atteneder, Clemens; Aliabadi-Zuckermann, Arezu; Laufer, G; Zuckermann, Andreas

doi:10.1016/j.healun.2022.01.116

Cited by 1 publication

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“…These findings support prior studies that have shown the CTS preservation system to be effective in maintaining graft function and good clinical outcomes post-transplant [16,[22][23][24]. Additionally, this study demonstrates comparable rates of IRI between ICS and CTS despite longer overall ischemic times with CTS.…”

Section: Discussionsupporting

confidence: 89%

Comparative Analysis of Ischemia‐Reperfusion Injury in Heart Transplantation: A Single‐Center Study Evaluating Conventional Ice‐Cold Storage versus the Paragonix SherpaPak Cardiac Transport System

Lotan,

Moeller,

Rahman

et al. 2024

Clinical Transplantation

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BackgroundSince the 2018 allocation system change in heart transplantation (HT), ischemic times have increased, which may be associated with peri‐operative and post‐operative complications. This study aimed to compare ischemia reperfusion injury (IRI) in hearts preserved using ice‐cold storage (ICS) and the Paragonix SherpaPak TM Cardiac Transport System (CTS).MethodsFrom January 2021 to June 2022, consecutive endomyocardial biopsies from 90 HT recipients were analyzed by a cardiac pathologist in a single‐blinded manner: 33 ICS and 57 CTS. Endomyocardial biopsies were performed at three‐time intervals post‐HT, and the severity of IRI manifesting histologically as coagulative myocyte necrosis (CMN) was evaluated, along with graft rejection and graft function.ResultsThe incidence of IRI at weeks 1, 4, and 8 post‐HT were similar between the ICS and CTS groups. There was a 59.3% statistically significant reduction in CMN from week 1 to 4 with CTS, but not with ICS. By week 8, there were significant reductions in CMN in both groups. Only 1 out of 33 (3%) patients in the ICS group had an ischemic time >240 mins, compared to 10 out of 52 (19%) patients in the CTS group. During the follow‐up period of 8 weeks to 12 months, there were no significant differences in rejection rates, formation of de novo donor‐specific antibodies and overall survival between the groups.ConclusionThe CTS preservation system had similar rates of IRI and clinical outcomes compared to ICS despite longer overall ischemic times. There is significantly more recovery of IRI in the early post operative period with CTS. This study supports CTS as a viable option for preservation from remote locations, expanding the donor pool.

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Section: Discussionsupporting

confidence: 89%