JTCVS Open (Oct 2024)

Out of the ice age: Preservation of cardiac allografts with a reusable 10 °C coolerCentral MessagePerspective

  • John M. Trahanas, MD,
  • Timothy Harris, MD,
  • Mark Petrovic, MS,
  • Anthony Dreher, MPA,
  • Chetan Pasrija, MD,
  • Stephen A. DeVries, PA-C,
  • Swaroop Bommareddi, MD,
  • Brian Lima, MD,
  • Chen Chia Wang, BSc,
  • Michael Cortelli, BS,
  • Avery Fortier, BSc,
  • Kaitlyn Tracy, MD,
  • Elizabeth Simonds, BA,
  • Clifton D. Keck,
  • Shelley R. Scholl, RN,
  • Hasan Siddiqi, MD,
  • Kelly Schlendorf, MD,
  • Matthew Bacchetta, MD,
  • Ashish S. Shah, MD

Journal volume & issue
Vol. 21
pp. 197 – 209

Abstract

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Objective: Static cold storage with ice has been the mainstay of cardiac donor preservation. Early preclinical data suggest that allograft preservation at 10 °C may be beneficial. We tested this hypothesis by using a static 10 °C storage device to preserve and transport cardiac allografts. Methods: In total, 52 allografts were recovered between July 2023 and March 2024 and transported using a 10 °C storage cooler. Results were compared to a 3:1 propensity match of allografts transported on ice. Patients were excluded for the following reasons: dual viscera transplant, previous heart transplant, complex congenital heart disease, or allograft injury during procurement. Results: Among the 10 °C cooler cohort, median total ischemic time was 222 minutes at 10 °C versus 193 minutes on ice (P .99). 10 °C hearts demonstrated less change in lactate but no difference in vasoactive inotrope scores or cardiac index. In hearts with extended ischemic time, delta lactate was lower in 10 °C cooler hearts. There was no statistical difference in outcomes for donor hearts >40 years old. Conclusions: This is an early experience of static preservation in a 10 °C cooler. Postoperative allograft function was excellent, and lactate profiles lower in those allografts with extended ischemic times. Static cold storage targeting 10 °C may offer an inexpensive method for extended heart preservation. Further investigation is needed to assess long-term outcomes of 10 °C storage.

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