Long‐term outcomes after heart transplantation using ex vivo allograft perfusion in standard risk donors: A single‐center experience

• Published in: Clinical transplantation 2022-05, Vol.36 (5), p.e14591-n/a
• Main Authors: Chen, Qiudong, Singer‐Englar, Tahli, Kobashigawa, Jon A., Roach, Amy, Emerson, Dominic, Megna, Dominick, Ramzy, Danny, Catarino, Pedro, Patel, Jignesh K., Kittleson, Michelle, Czer, Lawrence, Chikwe, Joanna, Esmailian, Fardad
• Format: Article
• Language: English
• Subjects: Allografts; heart (allograft) function/dysfunction; heart disease; Heart Diseases; Heart Transplantation - adverse effects; Humans; organ perfusion and preservation; Organ Preservation; patient survival; Perfusion; Tissue Donors
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.14591

Introduction The Organ Care System (OCS) is an ex vivo perfusion platform for donor heart preservation. Short/mid‐term post‐transplant outcomes after its use are comparable to standard cold storage (CS). We evaluated long‐term outcomes following its use. Methods Between 2011 and 2013, 38 patients from a single center were randomized as a part of the PROCEED II trial to receive allografts preserved with CS (n = 19) or OCS (n = 19). Endpoints included 8‐year survival, survival free from graft‐related deaths, freedom from cardiac allograft vasculopathy (CAV), non‐fatal major adverse cardiac events (NF‐MACE), and rejections. Results Eight‐year survival was 57.9% in the OCS group and 73.7% in the CS group (p = .24). Freedom from CAV was 89.5% in the OCS group and 67.8% in the CS group (p = .13). Freedom from NF‐MACE was 89.5% in the OCS group and 67.5% in the CS group (p = .14). Eight‐year survival free from graft‐related death was equivalent between the two groups (84.2% vs. 84.2%, p = .93). No differences in rejection episodes were observed (all p > .5). Conclusions In select patients receiving OCS preserved allografts, late post‐transplant survival trended lower than those transplanted with an allograft preserved with CS. This is based on a small single‐center series, and larger numbers are needed to confirm these findings.