(304) Graft Preservation in Heart Transplantation: Clinical and Histological Results Using Three Different Techniques

• Published in: The Journal of heart and lung transplantation Vol. 42; no. 4; p. S145
• Main Authors: Lechiancole, A., Sponga, S., Vendramin, I., Ferrara, V., Benedetti, G., Guzzi, G., Nalli, C., Nora, C. Di, Calandruccio, R.M., Brindicci, Y., Bressan, M., Livi, U.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2023.02.1608

Alongside the classical cold storage with ice, other techniques for graft preservation are increasingly used. The purpose of this study is to analyze the results of Heart Transplantation (HTx) in relation to the preservation technique of the graft. Between 2020 and 2022, 55 patients received HTx with grafts preserved with iced-cold storage (CS, n=27), normothermic perfusion with Organ-Care-System (OCS, n=15), and controlled 4°C hypothermia with Paragonix SherpaPak (SP, n=13). The three groups were compared for clinical characteristics, results and iystological graft examinations. Compared to the CS, OCS and SP patients had a higher IMPACT score (p=0.08) and more LVAD support (p=0.01). Extended-criteria donor rate was similar between groups, while ischemic time significantly reduced in OCS (p<0.01). 30-day mortality and PGD≥moderate grade were 1(4%), 2(13%) e 1(7%) (p=0.33) and 1(4%), 3(20%) e 0% (p=0.11) among CS, OCS and SP. Overall and cardiac-related 1-year mortality were 1(4%), 2(13%), 1(7)% (p=0.03) and 0%, 2 (13%), 0% (p=0.21) among groups CS, OCS and SP. After preservation and prior to the implant, grafts preserved with ice were more likely to show edema, while those preserved with normothermic perfusion developped more hemorrhagic lesions. Controlled hypothermia and normothermic perfusion were adopted in increasingly complex and high-risk scenarios with satisfactory results. In relation to the characteristics of donors and recipients, the graft preservation technique could have an impact on the outcomes after HTx