The cold truth: Myocardial temperatures and graft function achieved with cold static storage

We aimed to investigate myocardial temperatures of allografts after removal from cold static storage (CSS) and the relationship between temperature and early outcomes of heart transplantation (HT). Between January and September 2024, 22 allografts preserved with CSS underwent prospective temperature measurements at the left ventricular free wall (LVFW) and interventricular septum; preservation solution temperatures were also measured. Median LVFW temperature was 4.0°C, septal temperature was 3.9°C, and solution temperature was 3.7°C. LVFW and septal temperatures were significantly correlated (p < 0.001), as were septal and solution temperatures (p = 0.03). Ischemic time inversely correlated with solution temperature (p = 0.021), and septal thickness correlated with septal temperature (p = 0.04). One patient developed severe primary graft dysfunction, and 30-day recipient and graft survival were 100% (22/22). We conclude that CSS maintains myocardial temperatures near 4°C, and it can achieve excellent post-HT outcomes with a low incidence of PGD.