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Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion
Published on: November 28, 2025
540
The donor heart and organ perfusion technology
Hong Chee Chew1,2, Peter S Macdonald1,2, Kumud K Dhital1,2
1Heart and Lung Clinic, St Vincent's Hospital, Sydney, Australia.
Journal of Thoracic Disease
|June 12, 2019
Summary
Organ perfusion technology enables distant cardiac allograft procurement, expanding transplantation options. This method preserves hearts, assesses viability, and has facilitated over 100 donation after circulatory death heart transplants.
Area of Science:
- Cardiology
- Transplantation Medicine
- Biomedical Engineering
Background:
- Advancements in organ perfusion technology allow transplantation of marginal donor organs.
- Ex-situ heart perfusion extends preservation beyond cold static storage limitations.
- Perfusion systems maintain cell integrity, reducing ischemic injury and assessing organ viability.
Purpose of the Study:
- To review current experiences and outcomes with cardiac perfusion technology in transplantation.
- To highlight recent advancements and future technologies in cardiac preservation.
- To discuss the impact of perfusion technology on utilizing marginal and donation after circulatory death (DCD) organs.
Main Methods:
- Review of clinical outcomes and technological advancements in ex-situ heart perfusion.
- Analysis of data from centers utilizing cardiac perfusion for organ preservation and transplantation.
- Focus on normothermic machine perfusion (NMP) and its application in DCD heart transplantation.
Main Results:
- Cardiac perfusion technology facilitates distant procurement of cardiac allografts.
- Normothermic machine perfusion (NMP) enabled the first distant DCD heart procurement in 2014.
- Over 100 DCD heart transplants have been performed using perfusion systems, increasing transplant activity by 10-15% in participating centers.
Conclusions:
- Cardiac perfusion technology significantly enhances the utilization of marginal and DCD donor hearts.
- Ex-situ perfusion offers a platform for organ assessment and potential therapeutic interventions.
- The adoption of DCD heart transplantation, enabled by perfusion systems, is expanding global transplant capacity.
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