Simultaneous Heart-Liver Transplant Using Dual-Organ Normothermic Machine Perfusion Following Donation After...

Area of Science:

• Cardiovascular Surgery
• Hepatobiliary Surgery
• Transplantation Medicine

Background:

• Combined heart-liver transplantation is complex, especially with extended organ preservation times.
• Hemodynamic instability post-cardiac implantation poses challenges.
• Normothermic machine perfusion (NMP) offers an alternative to static cold storage for maintaining organ viability.

Purpose of the Study:

• To report the first successful combined heart-liver transplant utilizing NMP for both organs.
• To evaluate the efficacy of NMP in preserving organ quality from donation after circulatory death (DCD) donors.
• To assess short-term outcomes in a patient undergoing this complex procedure.

Main Methods:

• Procurement of heart and liver from a DCD donor.
• Preservation of both organs using the TransMedics Organ Care System (NMP).
• Combined heart-liver transplantation in a 45-year-old male recipient with ischemic cardiomyopathy and end-stage liver disease.

Main Results:

• Successful transplantation with total crossclamp times of 7.75 hours (heart) and 15.25 hours (liver).
• Patient demonstrated stable cardiac and hepatic graft function at 8 months post-transplant.
• NMP optimized organ quality and mitigated ischemic injury.

Conclusions:

• NMP is critical for optimizing organ quality in multi-organ transplants from DCD donors.
• This case supports the expanded use of NMP in complex, high-risk multi-organ transplants.
• NMP enhances organ utilization and improves outcomes in challenging transplant scenarios.