{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:30:43Z","timestamp":1792056643762,"version":"4.4.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>A preservation system, the Organ Care System (OCS; TransMedics) uses normothermic pulsatile perfusion during organ transport for heart transplantation. This system has demonstrated favorable outcomes in hearts recovered from extended-criteria donors after brain death (DBD) and donors after circulatory death (DCD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>The OCS Heart Perfusion Registry collects data on US heart transplantations using the OCS, static cold storage (SCS), or thoracoabdominal normothermic regional perfusion (NRP) and donor hearts recovered from DBD or DCD donors. We analyzed donor and recipient characteristics and posttransplantation outcomes in patients transplanted with OCS donor hearts (either DBD or DCD) compared with SCS hearts, and with OCS hearts from DCD donors compared with those recovered with NRP followed by SCS. Propensity score matching was used in survival analyses to adjust for differences among recipient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Between 2021 and 2023, 3225 consecutive heart transplantations enrolled from 56 centers were analyzed in the Heart Perfusion Registry. The OCS was used in 854 of 3225 heart transplantations (26.4%), among which 340 (39.8%) were DBD and 514 (60.2%) were DCD donors, whereas 2174 DBD donors were recovered with SCS and another 197 DCD donors with NRP techniques. The OCS-DBD group experienced a greater number of organ offer refusals before final acceptance (13 versus 6; Wilcoxon rank sum,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and a longer transport distance (667 miles versus 232 miles; Wilcoxon rank sum,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) compared with SCS-DBD. Survival at 12 months was similar between the 2 groups (89.9% for OCS-DBD versus 90.6% for SCS-DBD; marginal Cox model,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.54). Among the OCS-DCD and SCS-DBD groups, survival at 12 months was also similar (91.0% versus 92.5%, respectively; marginal Cox model,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.32). The OCS-DCD and NRP-DCD groups demonstrated similar survival (91.0% versus 91.7%, respectively; log rank,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.63), although the transport distance was longer in OCS-DCD compared with DCD with NRP followed by SCS (400 miles versus 223 miles; Wilcoxon rank sum,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). By 2023, 90% of all OCS donor management and recovery was performed with dedicated organ recovery teams.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>We demonstrate that real-world implementation of the OCS for DBD donors (using predominantly a dedicated recovery team) is associated with expanded donor criteria, longer transport distance, and excellent posttransplantation outcomes. In OCS-DCD donors, outcomes parallel those of donors recovered with NRP-DCD and compare favorably with DBD donor organs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.124.071743","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T05:01:33Z","timestamp":1741323693000},"page":"896-909","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Clinical Outcomes With Normothermic Pulsatile Organ Perfusion in Heart Transplantation: A Report From the OCS Heart Perfusion Registry"],"prefix":"10.1161","volume":"151","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7362-0513","authenticated-orcid":true,"given":"Josef","family":"Stehlik","sequence":"first","affiliation":[{"name":"University of Utah, Salt Lake City (J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1066-9368","authenticated-orcid":true,"given":"Maryjane A.","family":"Farr","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center, Dallas, TX (M.A.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8683-7044","authenticated-orcid":true,"given":"Mandeep R.","family":"Mehra","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA (M.R.M., A.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5836-7284","authenticated-orcid":true,"given":"Jacob N.","family":"Schroder","sequence":"additional","affiliation":[{"name":"Duke University Hospital, Durham, NC (J.N.S., C.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9693-7313","authenticated-orcid":true,"given":"David A.","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Boston (D.A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5208-2771","authenticated-orcid":true,"given":"Jay D.","family":"Pal","sequence":"additional","affiliation":[{"name":"University of Washington Medical Center, Seattle (J.D.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-9471","authenticated-orcid":true,"given":"Mauricio A.","family":"Villavicencio","sequence":"additional","affiliation":[{"name":"Mayo Clinic Hospital Minnesota, Rochester (M.A.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7356-905X","authenticated-orcid":true,"given":"Peter J.","family":"Gruber","sequence":"additional","affiliation":[{"name":"Yale New Haven Hospital, New Haven, CT (P.J.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Couper","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, MA (G.S.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4545-1273","authenticated-orcid":true,"given":"Yasuhiro","family":"Shudo","sequence":"additional","affiliation":[{"name":"Stanford Health Care, Palo Alto, CA (Y.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2761-5895","authenticated-orcid":true,"given":"Parag C.","family":"Patel","sequence":"additional","affiliation":[{"name":"Mayo Clinic Hospital Florida, Jacksonville (P.C.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-9911","authenticated-orcid":true,"given":"Mani A.","family":"Daneshmand","sequence":"additional","affiliation":[{"name":"Emory University Hospital, Atlanta, GA 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