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Published on: January 12, 2019
The basic science aspect of donor heart preservation: a review
Andrew L Rivard1, Robert P Gallegos, Richard W Bianco
1Department of Physiology, University of Minnesota, Minneapolis, Minnesota 55455, USA. rivar011@umn.edu
Insights
Donor heart preservation is key in cardiac transplantation. Advances in preservation techniques and cardioplegic solutions extend heart viability, potentially increasing the donor pool and improving outcomes.
Area of Science:
- Cardiology
- Transplantation Medicine
- Biomedical Engineering
Background:
- Donor heart viability limits transport time in cardiac transplantation.
- Established preservation techniques include hypothermia, perfusion, oxygenation, and hyperbaria.
- Ongoing development of cardioplegic solutions addresses edema and oxygen radical formation.
Purpose of the Study:
- To review advancements in donor heart preservation.
- To explore the potential of new research in cell death mechanisms for improved preservation solutions.
- To discuss the impact of extended preservation times on the donor pool and patient outcomes.
Main Methods:
- Review of historical and current preservation techniques for transplantable hearts.
- Analysis of the role of cardioplegic solutions in minimizing cellular damage.
- Discussion of emerging research into necrosis, oncosis, and apoptosis.
Main Results:
- Cardioplegic solution development has extended donor heart viability.
- Minimizing edema and oxygen radical formation are key benefits.
- New research may lead to further advancements in preservation.
Conclusions:
- Extended donor heart preservation is achievable through evolving solutions and technologies.
- Increased preservation time can expand the donor heart pool.
- Improved donor heart viability is expected to enhance post-operative outcomes in cardiac transplantation.
Abstract:
In cardiac transplantation, the transport time between harvest and recipient is limited by the viability of the donor heart. The problem of viability is a consistent limitation in cardiac transplantation. Since the 1960s, techniques, including hypothermia, perfusion, oxygenation, and hyperbaria, have been used to prolong the preservation of the transplantable heart. Continuing development of cardioplegic solutions has minimized edema and oxygen radical formation, which have resulted in extension of the donor heart viability. New research into the events leading to necrosis, oncosis, and apoptosis may allow further advancement of protective cardioplegic solutions in combination with technology of transporting the heart. With a prolonged preservation time there is potential to increase the donor pool and ultimately improve post-operative outcomes.
