Advances in cardiac machine perfusion: Exceeding 8 hours from procurement to implant without requiring ECMO

Emmanuel S, Muthiah K, Tardo D, MacDonald P, Hayward C, McGiffin D, Kaye D, Fraser J, Jansz P J Heart Lung Transplant DOI: 10.1016/j.healun.2023.08.003

Abstract: Prolonged Donor Ischaemic Time (DIT) is a well-documented limitation to carrying out heart transplantation. Most centres accept a DIT of less than 4 hours in cold static storage, with concerns that exceeding this time may result in primary graft dysfunction. Cardiac machine perfusion is an emerging technology to improve organ preservation in transit. There are reports of hearts preserved using the Transmedics Organ Care System withstanding periods of 10 and 16 hours. However, in these case reports, the hearts required ECMO post-operatively, suggesting early graft dysfunction.

This case report describes a heart that was procured on the XVIVO non-ischaemic hypothermic perfusion (NIHP) device. Patient consent for inclusion in research publications was obtained at the time of listing for heart transplant.