Normothermic donor heart perfusion: current clinical experience and the future

Area of Science:

• Cardiovascular Surgery
• Transplantation Medicine
• Medical Device Technology

Background:

• Over 100,000 heart transplants performed globally since 1967.
• Current reliance on cold ischaemic preservation presents logistical limitations and restricts transplant volume.
• Limitations of cold storage impact immediate success rates and annual donor heart utilization.

Purpose of the Study:

• To review the historical development of normothermic donor heart perfusion.
• To examine the clinical experience with the TransMedics Organ Care System (OCS).
• To explore future potential applications of normothermic perfusion technology in heart transplantation.

Main Methods:

• Review of historical advancements in normothermic perfusion techniques for donor hearts.
• Analysis of clinical data and outcomes associated with the TransMedics OCS.
• Speculative discussion on the future trajectory of normothermic perfusion in cardiac transplantation.

Main Results:

• Normothermic perfusion technology, exemplified by the TransMedics OCS, has emerged in the last decade.
• The TransMedics OCS is the sole commercially available device enabling normothermic transport of donor hearts.
• Clinical experience with the OCS is accumulating, suggesting potential benefits over traditional methods.

Conclusions:

• Normothermic donor heart perfusion represents a significant technological advancement in transplantation.
• The TransMedics OCS offers a viable alternative to cold ischaemic preservation, addressing its inherent limitations.
• This innovative technology holds considerable promise for enhancing the success and scope of heart transplantation.