Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage
Abstract Background Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13019-020-01367-w |
| _version_ | 1818192425139568640 |
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| author | Rymbay Kaliyev Timur Lesbekov Serik Bekbossynov Zhuldyz Nurmykhametova Makhabbat Bekbossynova Svetlana Novikova Assel Medressova Nurlan Smagulov Linar Faizov Robertas Samalavicius Yuriy Pya |
| author_facet | Rymbay Kaliyev Timur Lesbekov Serik Bekbossynov Zhuldyz Nurmykhametova Makhabbat Bekbossynova Svetlana Novikova Assel Medressova Nurlan Smagulov Linar Faizov Robertas Samalavicius Yuriy Pya |
| author_sort | Rymbay Kaliyev |
| collection | DOAJ |
| description | Abstract Background Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS). Methods Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n = 25) versus standard cold storage (n = 10) were included in this study. Results During this period, 353 patients were implanted with left ventricular assisted device (LVAD) and 35 (10%) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p = 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p = 0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p = 0.002). All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p = 0.5). Conclusion Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support. |
| first_indexed | 2024-12-12T00:30:18Z |
| format | Article |
| id | doaj.art-4f2b49cf541545e7a040ffe3705df7b6 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-12T00:30:18Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-4f2b49cf541545e7a040ffe3705df7b62022-12-22T00:44:30ZengBMCJournal of Cardiothoracic Surgery1749-80902020-10-011511610.1186/s13019-020-01367-wHeart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storageRymbay Kaliyev0Timur Lesbekov1Serik Bekbossynov2Zhuldyz Nurmykhametova3Makhabbat Bekbossynova4Svetlana Novikova5Assel Medressova6Nurlan Smagulov7Linar Faizov8Robertas Samalavicius9Yuriy Pya10National Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryNational Research Center for Cardiac SurgeryVilnius University Hospital Santariskiu KlinikosNational Research Center for Cardiac SurgeryAbstract Background Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS). Methods Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n = 25) versus standard cold storage (n = 10) were included in this study. Results During this period, 353 patients were implanted with left ventricular assisted device (LVAD) and 35 (10%) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p = 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p = 0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p = 0.002). All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p = 0.5). Conclusion Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support.http://link.springer.com/article/10.1186/s13019-020-01367-wHeart transplantationEx vivo organ preservationMechanical circulatory supportHigh-risk recipients |
| spellingShingle | Rymbay Kaliyev Timur Lesbekov Serik Bekbossynov Zhuldyz Nurmykhametova Makhabbat Bekbossynova Svetlana Novikova Assel Medressova Nurlan Smagulov Linar Faizov Robertas Samalavicius Yuriy Pya Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage Journal of Cardiothoracic Surgery Heart transplantation Ex vivo organ preservation Mechanical circulatory support High-risk recipients |
| title | Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage |
| title_full | Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage |
| title_fullStr | Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage |
| title_full_unstemmed | Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage |
| title_short | Heart transplantation of patients with ventricular assist devices: impact of normothermic ex-vivo preservation using organ care system compared with cold storage |
| title_sort | heart transplantation of patients with ventricular assist devices impact of normothermic ex vivo preservation using organ care system compared with cold storage |
| topic | Heart transplantation Ex vivo organ preservation Mechanical circulatory support High-risk recipients |
| url | http://link.springer.com/article/10.1186/s13019-020-01367-w |
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