{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:24:18Z","timestamp":1792661058892,"version":"4.5.0"},"reference-count":17,"publisher":"IMR Press","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HSF"],"abstract":"<p><b>Background:<\/b> Cold ischemia associated with cold static storage is an independent risk factor for primary allograft failure and survival of patients after orthotopic heart transplantation. The effects of normothermic ex vivo allograft blood perfusion on outcomes after orthotopic heart transplantation compared to cold static storage have been studied.<\/p><p><b>Methods:<\/b> In this prospective, nonrandomized, single-institutional clinical study, normothermic ex vivo allograft blood perfusion has been performed using an organ care system (OCS) (TransMedics, Andover, MA, USA). Included were consecutive adult transplantation patients who received an orthotopic heart transplantation (oHTx) without a history of any organ transplantation, in the absence of a congenital heart disorder as an underlying disease and not being in need of a combined heart-lung transplantation. Furthermore, patients with fixed pulmonary hypertension, ventilator dependency, chronic renal failure, or panel reactive antibodies >20% and positive T-cell cross-matching were excluded. Inclusion criteria for donor hearts was age of <55 years, systolic blood pressure >85 mmHg at the time of final heart assessment under moderate inotropic support, heart rate of <120 bpm at the time of explantation, and left ventricular ejection fraction >40% assessed by an transcutaneous echo\/Doppler study with the absence of gross wall motion abnormalities, absence of left ventricular hypertrophy, and absence of valve abnormalities. Donor hearts which were conventionally cold stored with histidine-tryptophan-ketoglutarate solution (Custodiol; Koehler Chemie, Ansbach, Germany) constituted the control group. The primary end point was the recipients' survival at 30 days and 1 and 2 years after their heart transplantation. Secondary end points were primary and chronic allograft failure, noncardiac complications, and length of hospital stay.<\/p><p><b>Results:<\/b> Over a 2-year period (January 2006 to July 2008), 159 adult cardiac allografts were transplanted. Twenty-nine were assigned for normothermic ex vivo allograft blood perfusion and 130 for cold static storage with HTK solution. Cumulative survival rates at 30 days and 1 and 2 years were 96%, 89%, and 89%, respectively, whereas in the cold static storage group survival after oHTx was 95%, 81%, and 79%. Primary graft failure was less frequent in the recipients of an oHTx who received a donor heart which had been preserved with normothermic ex vivo allograft blood perfusion using an OCS (6.89% versus 15.3%; <i>P<\/i> = .20). Episodes of severe acute rejection (23% versus 17.2%; <i>P<\/i> = .73), as well as, cases of acute renal failure requiring haemodialysis (25.3% versus 10%; <i>P<\/i> = .05) were more frequent diagnosed among recipients of a donor heart which had been preserved using the cold static storage. The length of hospital stay did not differ (26 days versus 28 days; <i>P<\/i> = .80) in both groups.<\/p><p><b>Conclusions:<\/b> Normothermic ex vivo allograft blood perfusion in adult clinical orthotopic heart transplantation contributes to better outcomes after transplantation in regard to recipient survival, incidence of primary graft dysfunction, and incidence of acute rejection.<\/p><\/jats:p>","DOI":"10.1532\/hsf98.2014332","type":"journal-article","created":{"date-parts":[[2014,7,7]],"date-time":"2014-07-07T21:52:59Z","timestamp":1404769979000},"page":"141","source":"Crossref","is-referenced-by-count":67,"title":["Normothermic Ex Vivo Allograft Blood Perfusion in Clinical Heart Transplantation"],"prefix":"10.31083","volume":"17","author":[{"given":"Michael M","family":"Koerner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ghodsizad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly","family":"El Banayosy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiner","family":"Koerfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gero","family":"Tenderich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2014,7,3]]},"reference":[{"key":"1","unstructured":"AQUA Institut. Annual report on cardiac transplantation of the German Federal Agency for Quality Assessment 2010. www-aqua-institut.de<\/a>"},{"key":"2","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.ejcts.2008.03.043","article-title":"Preserving and evaluating with ex-vivo machine perfusion: an avenue to improve early graft performance and expand the donor pool","volume":"34","author":"M. Collins","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"3","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.healun.2010.05.034","article-title":"The International Society for Heart and Lung Transplantation Guidelines for the care of heart transplant recipients","volume":"29","author":"M. Costanzo","year":"2010","journal-title":"J Heart Lung Transplant"},{"key":"4","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1056\/NEJMra071667","article-title":"Myocardial reperfusion injury","volume":"357","author":"M. Derek","year":"2007","journal-title":"N Engl J Med"},{"key":"5","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1161\/01.CIR.93.6.1133","article-title":"Heart transplantation-associated perioperative ischemic myocardial injury. Morphological features and clinical significance","volume":"93","author":"B. Fyfe","year":"1996","journal-title":"Circulation"},{"key":"6","doi-asserted-by":"crossref","DOI":"10.1532\/HSF98.20111146","article-title":"Ex vivo coronary angiography of a donor heart in the organ care system","volume":"15","author":"A. Ghodsizad","year":"2012","journal-title":"Heart Surg Forum"},{"key":"7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/TP.0b013e318190007d","article-title":"Live-years gained by reducing donor heart ischemic times","volume":"87","author":"K. Goldsmith","year":"2009","journal-title":"Transplantation"},{"key":"8","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/S0022-5223(98)00452-8","article-title":"Continuous perfusion of donor hearts in the beating state extends preservation time and improves recovery of function","volume":"116","author":"W. Hassanein","year":"1998","journal-title":"J Thorac Cardiovasc Surg"},{"key":"9","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.healun.2008.07.019","article-title":"Registry of the International Society for Heart and Lung Transplantation","volume":"27","author":"M. Hertz","year":"2008","journal-title":"J Heart Lung Transplant"},{"key":"10","first-page":"565","article-title":"The registry of the International Society for Heart and Lung Transplantation: fifteenth official report 1998","volume":"17","author":"J. Hosenpud","year":"1998","journal-title":"J Heart Lung Transplant"},{"key":"11","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/S1053-2498(00)00138-8","article-title":"The registry of the International Society for Heart and Lung Transplantation: seventeenth official report 2000","volume":"19","author":"J. Hosenpud","year":"2000","journal-title":"J Heart Lung Transplant"},{"key":"12","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1111\/j.1600-6143.2009.02807.x","article-title":"The pathophysiology of chronic graft failure in the cardiac transplant patient","volume":"9","author":"U. Khan","year":"2009","journal-title":"Am J Transplant"},{"key":"13","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/TP.0b013e3181e6f1eb","article-title":"Factors associated with primary graft failure after heart transplantation","volume":"90","author":"M. Russo","year":"2010","journal-title":"Transplantation"},{"key":"14","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.healun.2006.05.002","article-title":"Registry of the International Society for Heart and Lung Transplantation: twenty-third official adult heart transplantation report","volume":"25","author":"D. Taylor","year":"2006","journal-title":"J Heart Lung Transplant"},{"key":"15","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/00007890-199810270-00025","article-title":"Extended donor criteria: hemodynamic follow-up of heart transplant recipients receiving a cardiac allograft from donors > or = 60 years of age","volume":"66","author":"G. Tenderich","year":"1998","journal-title":"Transplantation"},{"key":"16","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.healun.2006.11.321","article-title":"Increasing organ availability in heart transplantation with use of warm perfusion for organ preservation","volume":"26","author":"G. Tenderich","year":"2007","journal-title":"J Heart Lung Transplant"},{"key":"17","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1056\/NEJMra071667","article-title":"Myocardial reperfusion injury","volume":"357","author":"D. Yellon","year":"2007","journal-title":"N Engl J Med"}],"container-title":["The Heart Surgery Forum"],"original-title":[],"link":[{"URL":"http:\/\/journal.hsforum.com\/index.php\/HSF\/article\/viewFile\/449\/450","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T10:13:10Z","timestamp":1766398390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/HSF\/17\/3\/10.1532\/HSF98.2014332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,3]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2014,6,1]]}},"URL":"https:\/\/doi.org\/10.1532\/hsf98.2014332","relation":{},"ISSN":["1522-6662","1098-3511"],"issn-type":[{"value":"1522-6662","type":"electronic"},{"value":"1098-3511","type":"print"}],"subject":[],"published":{"date-parts":[[2014,7,3]]}}}