Ex vivo donor heart preservation in heart transplantation

Heart Transplantation in High-Risk Recipients Employing Donor Marginal Grafts Preserved With Ex-Vivo Perfusion

“…Analysis of histological biopsy samples confirms that cardiomyocyte damage was either stable or even improved after reperfusion following HTx in EVP supported hearts, while after cold storage preservation donor grafts showed at histology worsening of myocardial damage after reperfusion [12]. Cardiomyocyte degeneration and edema increased after 6 h of support and, therefore, OCS perfusion longer than 8 h should be avoided [17]. This is supported by others who demonstrated that the length of time on OCS was a strong predictor of PGD [19].…”

“…It has been demonstrated that the time-dependent negative impact of ischemia on graft function depends on the donor age since prolonged ischemia is poorly tolerated by grafts from older donors [29]. Indeed, EVP provides a better myocardial protection, not only by allowing to limit the graft ischemic time, but also to assess and potentially recondition the donor heart [13][14][15][16][17]. Analysis of histological biopsy samples confirms that cardiomyocyte damage was either stable or even improved after reperfusion following HTx in EVP supported hearts, while after cold storage preservation donor grafts showed at histology worsening of myocardial damage after reperfusion [12].…”

“…HTx was performed using the bicaval anastomosis technique and immunosuppression therapy was standardized with steroids, calcineurin inhibitors and mycophenolate mofetil. Postoperative and long-term followup protocols at the University Hospital of Udine have been previously published and have remained unchanged during the study period [13][14][15][16][17]. In Hannover, all HTx recipients underwent triple immunosuppressive therapy with tacrolimus, prednisolone and mycophenolate mofetil.…”