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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
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Early clinical experience with a phase change material-based temperature-controlled cold-chain system for donor heart
Dong Youb Han1, Kitae Kim1, Ah Ram Kim2
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
JHLT Open
|March 20, 2026
Summary
A novel phase change material (PCM) container, VIXELL, maintained stable hypothermia for donor hearts during transport. This technology prevented temperature fluctuations, ensuring optimal conditions and avoiding severe primary graft dysfunction in heart transplant recipients.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Biomedical Engineering
Background:
- Conventional ice-box storage of donor hearts can lead to injurious temperature fluctuations.
- Maintaining a stable cold chain is critical for preventing donor heart injury during static cold storage.
Purpose of the Study:
- To evaluate a phase change material (PCM)-based temperature-controlled cold-chain container (VIXELL) for donor heart transport.
- To assess the feasibility and efficacy of VIXELL in maintaining optimal hypothermia during heart transplantation.
Main Methods:
- A single-center study involving 12 consecutive adult orthotopic heart transplantations.
- The VIXELL container was used to maintain donor hearts at 2°C-8°C during ground transport.
- Continuous temperature monitoring and assessment of severe primary graft dysfunction (PGD) using established criteria were performed.
Main Results:
- In-transit temperatures were consistently maintained within the target range of 2°C-8°C, regardless of transport duration.
- Cold ischemic time averaged 116.8 ± 59.6 minutes.
- Early graft function markers were favorable, with no instances of severe PGD, indicating successful hypothermic preservation.
Conclusions:
- PCM-based temperature control using VIXELL is a feasible method for providing stable hypothermia during donor heart transport.
- The VIXELL system effectively prevented freezing and excessive warming, contributing to favorable early graft function.
- Further large-scale comparative studies are recommended to validate these findings.
