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

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

Affiliations

John M. Trahanas, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn; Address for reprints: John M. Trahanas, MD, Department of Cardiac Surgery, Vanderbilt University Medical Center, 1215 21st Ave S, Suite 5025 Vanderbilt MCE, Nashville, TN 37232.
Timothy Harris, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Mark Petrovic, MS: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Anthony Dreher, MPA: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Chetan Pasrija, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Stephen A. DeVries, PA-C: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Swaroop Bommareddi, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Brian Lima, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Chen Chia Wang, BSc: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Michael Cortelli, BS: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Avery Fortier, BSc: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Kaitlyn Tracy, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Elizabeth Simonds, BA: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Clifton D. Keck: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Shelley R. Scholl, RN: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn
Hasan Siddiqi, MD: Department of Cardiology, Vanderbilt University Medical Center, Nashville, Tenn
Kelly Schlendorf, MD: Department of Cardiology, Vanderbilt University Medical Center, Nashville, Tenn
Matthew Bacchetta, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tenn
Ashish S. Shah, MD: Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tenn

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.

Published in JTCVS Open

ISSN: 2666-2736 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Surgery
Website: https://www.journals.elsevier.com/jtcvs-open

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