3-year outcomes with ex-vivo allograft perfusion for heart transplantation: Comparison of Custodiol vs warm blood cardioplegia and conditioning
Pya Yu.V. Kaliyev R.B. Bekbossynova M.S. Lesbekov T.D. Bekbossynov S.T. Kapyshev T.S. Nurmykhametova Zh.A. Novikova S.P. Smagulov N.K. Faizov L.R. Kuanyshbek A.S. Andossova S.A. Myrzakhmetova G.Sh. Turganbayeva G.M.
2021Nutritec
Clinical and Experimental Surgery
2021#8Issue 327 - 31 pp.
The Organ Care System (OCS) was introduced for more prolonged and reliable ex-vivo organ management. We reviewed our institutional experience to assess 3 year outcomes in patients of the standard Custodiol versus warm blood cardioplegia groups. Material and methods. Between May 2014 and September 2017, 43 patients after heart transplantation from single institution were randomized depending on the way of cardioplegia initiation. In 1st group (n=13) standard Custodiol solution was used to arrest the donor heart before explant and implant; in 2nd group (n=30) blood cardioplegia and conditioning were used for the same purpose. 3-year survival, freedom from cardiac allograft vasculopathy (CAV), any-treated rejection (ATR) and non-fatal major cardiac events (NF-MACE) in 3 years were assessed. Results. Recipient demographic characteristics in each group were similar. There was no significant difference in the 3-year patient survival rate between the two groups (Standard Custodiol group 77% vs Blood cardioplegia and conditioning group 67%, p=0.5). Similarly, there was no difference in freedom from CAV, ATR, and NF-MACE. Mean ex vivo perfusion time was 282.5±86.7 min in the blood cardioplegia group compared to 247.4±88.4 min in the standard care group (p=0.87). Conclusion. The outcome following heart transplantation after donor heart preservation with the organ care system Custodiol vs warm blood cardioplegia and conditioning represents a promising platform for donor heart transportation with similar intermediate results.
Blood cardioplegia , Ex vivo heart perfusion , Heart transplantation
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National Research Center for Cardiac Surgery, Nur-Sultan, 010000, Kazakhstan
National Research Center for Cardiac Surgery
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