{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:54:30Z","timestamp":1786121670722,"version":"build-2736575974"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"grants from Association Ouest-Transplant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Normothermic ex vivo heart perfusion (NEVHP) allows functional assessment and preservation of donor hearts, but the biological responses occurring during perfusion are not well characterized. This pilot study evaluated the feasibility of sequential biomarker monitoring during human cardiac NEVHP and described inflammatory, endothelial, and haemostatic responses over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This single-centre, prospective, observational pilot study included five consecutive donor hearts preserved with the TransMedics Organ Care System (OCS) at the University Hospital of Rennes between March 2021 and January 2023. OCS use was indicated for expected cold ischaemia &amp;gt;4\u2005h or surgical complexity. Perfusate samples were collected after priming (T0), at 10\u2005min (T1), 60\u2005min (T2), and before cooling (T3). Cytokines, chemokines, endothelial markers, and haemostatic factors were quantified by multiplex immunoassay and ELISA. Data were analysed using linear mixed-effects models and expressed as fold-change vs T0. Donor median age was 44 years (IQR 36\u201350) and 60% male. All grafts were transplanted. Recipient mean age was 53 \u00b1 9 years and 20% female. Two of five (40%) developed severe primary graft dysfunction. Sequential sampling was successful in all perfusions. Inflammatory mediators rose during perfusion: at T3 vs T0, IL-8 increased 11.5-fold (95% CI 6.5\u201320.1), bFGF 8.4-fold (6.7\u201310.5), IL-6 4.5-fold (2.4\u20138.2), and MCP-1\/CCL2 4.1-fold (2.6\u20136.6). IL-10 and TNF-\u03b1 showed smaller increases (2.0- and 1.6-fold). Leukocyte counts remained stable (0.57 \u00d7 109\/L at T0; fold-change 0.9). Endothelial markers showed activation without evidence of injury. Angiopoietin-2 increased 1.6-fold (1.2\u20132.1) and VEGF 2.0-fold (1.2\u20133.5), while angiopoietin-1, syndecan-1, soluble E-selectin, thrombomodulin, VEGFR2, PlGF, and vWF:Ag showed minimal or inconsistent changes. These trajectories are consistent with endothelial activation in the absence of glycocalyx shedding or structural disruption. Despite high heparin levels (median 6.9\u2005IU\/ml), low-grade haemostatic activation occurred. D-dimer increased 1.9-fold (1.3\u20132.7), fibrin monomer 2.2-fold (1.2\u20133.9), and soluble P-selectin 1.5-fold (1.1\u20132.0). Platelet counts declined to 0.8 (0.7\u20130.9) relative to baseline. Haematocrit decreased slightly (15.5% to 14.6%, fold-change 0.94), consistent with mild haemodilution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sequential biomarker monitoring during NEVHP was feasible and demonstrated inflammatory, endothelial, and haemostatic changes. These biological patterns require confirmation in larger cohorts, as potential tools for graft assessment and optimization of perfusion circuits and perfusate composition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag114","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:49:25Z","timestamp":1776430165000},"source":"Crossref","is-referenced-by-count":0,"title":["Endothelial and inflammatory responses during ex vivo normothermic perfusion of human cardiac grafts"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8955-2407","authenticated-orcid":false,"given":"Alexandre","family":"Mansour","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Univ Rennes, CHU Rennes, CIC 1414 (Centre d\u2019Investigation Clinique de Rennes), Inserm, IRSET, UMR_S 1085, FHU SUPORT , 35033 Rennes Cedex 9, F35000 Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Patou Parvedy","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Univ Rennes, CHU Rennes, Inserm , Institut NUMECAN \u2013 UMR_A 1341, UMR_S 1241, F-35000 Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliette","family":"Ferrant","sequence":"additional","affiliation":[{"name":"SITI, University Hospital of Rennes, Etablissement Fran\u00e7ais du Sang Bretagne , Rennes ,","place":["France"]},{"name":"UMR 1236, Univ Rennes, Inserm, Etablissement Fran\u00e7ais du Sang Bretagne, Equipe Labellis\u00e9e Ligue Contre le Cancer , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Gouin-Thibault","sequence":"additional","affiliation":[{"name":"Laboratory of Hematology, Pontchaillou University Hospital of Rennes. Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en sant\u00e9, environnement et travail) - UMR_S 1085 , F-35000 Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwan","family":"Flecher","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Pontchaillou, University Hospital of Rennes, University of Rennes 1, Signal and Image Treatment Laboratory (LTSI), Inserm U1099 , Rennes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Nesseler","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes), Inra, Institut NUMECAN \u2013 UMR_A 1341, UMR_S 1241 , FHU SUPORT, F-35000 Rennes 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