Investigating Cardiac Temperature During Heart Transplantation Using the Static Cold Storage Paradigm

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Organ Transplantation Science

Background:

• Static cold storage is fundamental to heart transplantation (HTx).
• Temperature dynamics within the heart during HTx remain largely uncharacterized.
• This study addresses the knowledge gap in thermal profiles throughout the HTx process.

Purpose of the Study:

• To quantify the duration of heart cooling and warming during HTx.
• To characterize the temperature distribution within the heart at each HTx stage.
• To provide critical data for optimizing HTx procedures and organ preservation.

Main Methods:

• Utilized high-fidelity computational time-varying biothermal modeling.
• Employed an anatomical human heart model.
• Simulated 5 interdependent stages of the HTx process, from cardioplegia to reperfusion.

Main Results:

• Hearts undergo rapid cooling to below 10°C within 15 minutes, with a maximum cooling rate of 5°C/min.
• Hearts experience extended periods below 2°C during static cold storage.
• Warming to body temperature occurs rapidly (within 10 minutes) upon reperfusion, with heterogeneous rates between the left and right sides (2°C/min and 4°C/min, respectively).
• Significant temperature heterogeneity exists, with the right side warming nearly twice as fast as the left.

Conclusions:

• This study provides the first detailed temperature distribution and evolution data for each stage of HTx.
• The rapid and heterogeneous temperature changes identified are critical for enhancing heart graft viability.
• Quantifying these thermal dynamics can lead to optimized HTx protocols and improved patient outcomes.