HMP revolutionises heart transplantation

For the last 50 years of cardiac transplantation, donor hearts have been preserved during the ischaemic time by storage in ice slush (cold static storage).

There are substantial limits to this method of preservation, a major one being that the ischaemic time is limited to approximately four to five hours. After this time, the risk of primary graft dysfunction (PGD) and death progressively increases.

In a country the size of Australia, the safe ischaemic time limit of cold static storage imposes geographical constraints on the distances the donor heart can be transported. Consequently, there are donor hearts that are sometimes not able to be transplanted because the ischaemic time would be too long.

Hypothermic machine perfusion (HMP) as an alternative to cold static storage has been undergoing extensive investigation in Australia and Aotearoa New Zealand. The concept of HMP is not new, but it’s the first time the Swedish-developed technology has been investigated outside Europe. The principles of HMP are low pressure, low-flow perfusion at eight degrees centigrade.

ABOVE: CCRG’s John Fraser and Prof David McGiffin; 24-year-old donor heart recipient Alex M with the rig that transported her heart a record time; and recovering from surgery in Perth

Article originally published in Surgical News Volume 24 Issue 2