Current preservation technology and future prospects of thoracic organs. Part 2: heart

The problem of organ shortage continuously emphasizes the importance of proper donor management and selection, organ preservation and recipient selection and treatment. This review summarizes state of the art of cardiac allograft preservation with special regard to recent clinical and experimental findings.

Over the past years no major strategy changes have found their way to the clinical setting of cardiac allograft preservation. Static, antegrade, cold, crystalloid flush perfusion is still the commonly used technique to preserve the heart. The importance of electrolyte composition, substrates and ischemia/reperfusion injury inhibiting additives are discussed with special attention to recent findings. Machine perfusion during preservation has regained attention over recent years and has led to the first clinical safety and feasibility trials in Europe and the USA.

No major changes were introduced in the technique of heart preservation over the past years. Many new ideas based upon experimental data were postulated but still have to find their way to the clinical setting.There is a renewed interest in mechanical perfusion. Everyone is curiously awaiting the first clinical reports.