Comparison of Custodiol vs warm blood cardioplegia and conditioning of donor hearts during transportation with the organ care system

Kaliyev, Rymbay; Lesbekov, Timur; Bekbossynov, Serik; Bekbossynova, Makhabbat; Nurmykhametova, Zhuldyz; Новикова, С. В.; Смагулов, Н. К.; Medressova, Assel; Faizov, Linar; Ashyrov, Zhanibek; Fleur, Philip la; Samalavičius, Robertas; Pya, Yuriy

doi:10.1111/jocs.14162

Cited by 12 publications

(16 citation statements)

References 21 publications

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“…Based on results from the PROCEED II trial, which implied that a rising lactate level more than 5 mmol/L on the system is a predictor of donor heart abnormality, we made the decision to use the OCS for the assessment of extended criteria donor hearts. Therefore, we compared the results of standard preservation modification with the new approach, using ultrafiltration, levosimendan and blood cardioplegia for conditioning of donor heart during ex vivo perfusion [ 11 ]. Ex vivo assessment combined with conditioning would minimize the risk of primary allograft dysfunction and potentially increase the donor pool.…”

Section: Discussionmentioning

confidence: 99%

Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage

Kaliyev¹,

Lesbekov²,

Bekbossynov³

et al. 2020

J Cardiothorac Surg

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Background Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS). Methods Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n = 25) versus standard cold storage (n = 10) were included in this study. Results During this period, 353 patients were implanted with left ventricular assisted device (LVAD) and 35 (10%) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p = 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p = 0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p = 0.002). All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p = 0.5). Conclusion Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support.

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Section: Discussionmentioning

confidence: 99%

Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage

Kaliyev¹,

Lesbekov²,

Bekbossynov³

et al. 2020

J Cardiothorac Surg

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“…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%

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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“…The OCS standard protocol allows for extended preservation out of body time of 8 hours, for organ procurement, reducing the detrimental effects of cold ischemic storage, improving short-term heart allograft function. In our center, we allow for extended out of body time (more than 8 hours as mentioned above) due to geographical distances between donor and recipient hospitals (11).…”

Section: Discussionmentioning

confidence: 99%

“…OCS Heart allowed safe transplantation of recipients on Mechanical Circulatory Support. Despite preservation mean time was approaching 7 hours (maximum 16) enabling allocations otherwise not acceptable, patient and graft conditions were favorable (11). The ex vivo heart perfusion allows optimization of logistics and meticulous preparation of the recipients with MCS.…”

Section: Discussionmentioning

confidence: 99%

Heart Transplantation of Patients with Ventricular Assist Devices: Impact of Normothermic Ex-Vivo Preservation Using Organ Care System Compared with Cold Storage

Nurmykhametova

Kaliyev

Lesbekov

et al. 2020

Preprint

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Background: Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS). Methods: Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n=25) versus standard cold storage were included in this study. Results: During this period, 300 patients were implanted with left ventricular assisted device (LVAD) and 35 (11.6 %) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p= 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p=0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p=0.002). The allografts were reperfused for 73 (33) vs 121 (45) minutes (p=0.01) before disconnection from cardiopulmonary bypass in OCS vs CS group. All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p=0.5). Conclusion: Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support.

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Comparison of Custodiol vs warm blood cardioplegia and conditioning of donor hearts during transportation with the organ care system

Cited by 12 publications

References 21 publications

Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage

Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage

Machine Perfusion for Human Heart Preservation: A Systematic Review

Heart Transplantation of Patients with Ventricular Assist Devices: Impact of Normothermic Ex-Vivo Preservation Using Organ Care System Compared with Cold Storage

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