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Updated: Aug 5, 2026

Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion
08:15

Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion

Published on: November 28, 2025

Advances in Heart Preservation Techniques for Transplantation: An Updated Review

Chananya Karunasumetta1, Ienglam Lei2,3, Paul C Tang2,4

  • 1Mayo Clinic, Department of Cardiovascular Surgery, Rochester, Minnesota, United States; Karunasumetta.Chananya@mayo.edu.

Canadian Journal of Physiology and Pharmacology
|July 31, 2026
PubMed

Insights

Donor heart preservation is crucial for heart transplant success. New methods like normothermic ex vivo perfusion (NEHP) and hypothermic oxygenated perfusion (HOPE) improve outcomes, especially for high-risk organs, overcoming limitations of static cold storage (SCS).

Area of Science:

  • Cardiovascular Surgery
  • Transplantation Immunology
  • Organ Preservation

Background:

  • Heart transplantation is the gold standard for end-stage heart failure.
  • Donor heart preservation directly impacts graft function and patient outcomes.
  • Traditional static cold storage (SCS) has limitations, particularly for marginal and donation after circulatory death (DCD) organs.

Purpose of the Study:

  • To review current donor heart preservation techniques.
  • To discuss strategies for mitigating ischemia-reperfusion injury.
  • To highlight emerging trends and future research in heart preservation.

Main Methods:

  • Review of current literature on heart preservation.
  • Analysis of emerging techniques like normothermic ex vivo perfusion (NEHP) and hypothermic oxygenated perfusion (HOPE).
  • Discussion of mechanisms to reduce ischemia-reperfusion injury.

Main Results:

  • NEHP and HOPE offer extended preservation and functional assessment capabilities.
  • These advanced methods improve the utilization of high-risk donor organs.
  • They show promise in overcoming SCS limitations for marginal and DCD hearts.

Conclusions:

  • Advanced preservation techniques like NEHP and HOPE are transforming heart transplantation.
  • Optimizing donor organ preservation is key to improving post-transplant outcomes.
  • Further research is needed to refine these methods and expand their application.

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