{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:49:36Z","timestamp":1791614976559,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ex vivo perfusion (EVP) in heart transplantation (HTX) enables transportation of explanted organs over longer distances as well as monitoring of cardiac metabolism under unloaded coronary perfusion, thereby expanding the possible pool of suitable donors for HTX. We aimed at identifying possibly modifiable risk factors predicting impaired outcome after HTX through analysis of perfusion parameters, donor and recipient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 64 patients after HTX using EVP (TransMedics Organ Care System) between February 2010 and October 2022 in this retrospective, single-center analysis. Blood gas analyses were taken during EVP in a standardized manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HTX recipients were 44.8 \u00b1 16.2\u00a0years old, six patients being younger than 18\u00a0years at the time of transplantation. High urgency listing status was present in 79.7%, and 67.2% had previous cardiac surgery. Lower base excess during EVP predicted severe primary graft dysfunction (PGD) (\u22125.55 \u00b1 1.95 vs \u22123.94 \u00b1 2.38\u00a0mmol\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.043). With every additional minute of warm ischemia, the risk of PGD was 3.7% higher (OR 1.037, 95% CI [1.004; 1.072],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.028). Low donor serum potassium (3.4 \u00b1 0.76\u00a0mmol\/L vs 4.2 \u00b1 0.60,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008), high glucose after EVP priming (207.63 \u00b1 99.05\u00a0mg\/dL vs 146.45 \u00b1 51.99,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.045), and resuscitation of the donor (55.6% vs 18.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.027) were associated with impaired survival after HTX.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EVP provides a unique method to assess graft function during the retrieval of hearts for cardiac transplantation. Low base excess, priming glucose, warm ischemia and donor hypokalaemia influence the frequency of adverse outcomes after HTX. Future studies may address possible strategies to safely modify these risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251413738","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T07:38:13Z","timestamp":1768030693000},"page":"1223-1230","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prediction of primary graft dysfunction and survival in heart transplantation using normothermic ex-vivo perfusion of the donor heart"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9380-7860","authenticated-orcid":false,"given":"Julius","family":"Borger","sequence":"first","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"B\u00e4uerlein","sequence":"additional","affiliation":[{"name":"University of Freiburg"},{"name":"Furtwangen University of Applied Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Berchtold-Herz","sequence":"additional","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Eschenhagen","sequence":"additional","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Fleck","sequence":"additional","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Haimerl","sequence":"additional","affiliation":[{"name":"Furtwangen University of Applied Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Benk","sequence":"additional","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedhelm","family":"Beyersdorf","sequence":"additional","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Czerny","sequence":"additional","affiliation":[{"name":"University of Freiburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Maier","sequence":"additional","affiliation":[{"name":"University of Freiburg"},{"name":"Furtwangen University of Applied Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7597-7778","authenticated-orcid":false,"given":"David","family":"Schibilsky","sequence":"additional","affiliation":[{"name":"University of Freiburg"},{"name":"Luzerner Kantonsspital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezz107"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.07.019"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.08.004"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.02.027"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-019-09794-1"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2023.11.015"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.12.025"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2024.03.010"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01078-X"},{"issue":"2","key":"e_1_3_6_12_2","first-page":"247","article-title":"Ex-Vivo preservation with the organ care system in high risk heart transplantation","volume":"12","author":"Rojas SV","year":"2022","unstructured":"Rojas SV, Avsar M, Ius F, et al. Ex-Vivo preservation with the organ care system in high risk heart transplantation. 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