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Mid-term follow-up of non-ischemic heart preservation in heart transplantation

Jernryd, Victoria LU ; Braun, Oscar LU ; Paskevicius, Audrius LU ; Metzsch, Carsten LU orcid ; Lofman, Ida Haugen ; Ragnarsson, Sigurdur LU ; Papageorgiou, Joanna Maria ; Ingvarsson, Annika LU orcid ; Steen, Stig LU and Nilsson, Johan LU orcid (2025) In JHLT Open 9.
Abstract

Background: Ex-vivo perfusion of donor hearts is gaining importance in minimizing ischemia-reperfusion injury during heart transplantation. The Non-Ischemic Heart Preservation (NIHP) device, developed in 2016, has shown promising results in pilot studies. This study aims to compare the mid-term follow-up outcomes of NIHP with traditional Static Cold Storage (SCS) in heart transplantation. Methods: This hybrid cohort study included 47 patients. The primary outcome was event-free survival at one year, defined as survival free of severe primary graft dysfunction (PGD), extracorporeal membrane oxygenation (ECMO) use within 7 days, acute cellular rejection (ACR ≥ 2R), and death. Secondary outcomes included graft function, incidence of... (More)

Background: Ex-vivo perfusion of donor hearts is gaining importance in minimizing ischemia-reperfusion injury during heart transplantation. The Non-Ischemic Heart Preservation (NIHP) device, developed in 2016, has shown promising results in pilot studies. This study aims to compare the mid-term follow-up outcomes of NIHP with traditional Static Cold Storage (SCS) in heart transplantation. Methods: This hybrid cohort study included 47 patients. The primary outcome was event-free survival at one year, defined as survival free of severe primary graft dysfunction (PGD), extracorporeal membrane oxygenation (ECMO) use within 7 days, acute cellular rejection (ACR ≥ 2R), and death. Secondary outcomes included graft function, incidence of adverse events at one year, and overall survival. Results: At 1 year, event-free survival was observed in 12 of 15 patients (80%) in the NIHP group and 23 of 32 patients (72%) in the SCS group. No patients in the NIHP group developed severe PGD, compared to three patients in the SCS group. ACR ≥ 2R occurred in 2/15 (13%) of NIHP patients and 5/32 (16%) of SCS patients. Overall survival at 5 years was 14/15 (93%) for NIHP and 24/32 (75%) for SCS. Immediate graft function and markers of ischemia-reperfusion injury favored the NIHP group, with lower CK-MB and lactate levels post-transplantation. Adverse events were comparable between groups, although the NIHP group had fewer severe complications. Conclusions: The NIHP system demonstrated outcomes comparable to SCS in heart transplantation, with improved graft function and reduced markers of ischemia-reperfusion injury. Further research is required to confirm these findings.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ex-vivo preservation, Heart transplantation, Ischemia, Primary graft dysfunction, Survival
in
JHLT Open
volume
9
article number
100285
publisher
Elsevier
external identifiers
  • scopus:105014285361
ISSN
2950-1334
DOI
10.1016/j.jhlto.2025.100285
language
English
LU publication?
yes
id
134ff44f-01ba-40a3-8e31-7d871b1692f6
date added to LUP
2025-11-07 10:36:07
date last changed
2025-11-07 10:37:30
@article{134ff44f-01ba-40a3-8e31-7d871b1692f6,
  abstract     = {{<p>Background: Ex-vivo perfusion of donor hearts is gaining importance in minimizing ischemia-reperfusion injury during heart transplantation. The Non-Ischemic Heart Preservation (NIHP) device, developed in 2016, has shown promising results in pilot studies. This study aims to compare the mid-term follow-up outcomes of NIHP with traditional Static Cold Storage (SCS) in heart transplantation. Methods: This hybrid cohort study included 47 patients. The primary outcome was event-free survival at one year, defined as survival free of severe primary graft dysfunction (PGD), extracorporeal membrane oxygenation (ECMO) use within 7 days, acute cellular rejection (ACR ≥ 2R), and death. Secondary outcomes included graft function, incidence of adverse events at one year, and overall survival. Results: At 1 year, event-free survival was observed in 12 of 15 patients (80%) in the NIHP group and 23 of 32 patients (72%) in the SCS group. No patients in the NIHP group developed severe PGD, compared to three patients in the SCS group. ACR ≥ 2R occurred in 2/15 (13%) of NIHP patients and 5/32 (16%) of SCS patients. Overall survival at 5 years was 14/15 (93%) for NIHP and 24/32 (75%) for SCS. Immediate graft function and markers of ischemia-reperfusion injury favored the NIHP group, with lower CK-MB and lactate levels post-transplantation. Adverse events were comparable between groups, although the NIHP group had fewer severe complications. Conclusions: The NIHP system demonstrated outcomes comparable to SCS in heart transplantation, with improved graft function and reduced markers of ischemia-reperfusion injury. Further research is required to confirm these findings.</p>}},
  author       = {{Jernryd, Victoria and Braun, Oscar and Paskevicius, Audrius and Metzsch, Carsten and Lofman, Ida Haugen and Ragnarsson, Sigurdur and Papageorgiou, Joanna Maria and Ingvarsson, Annika and Steen, Stig and Nilsson, Johan}},
  issn         = {{2950-1334}},
  keywords     = {{Ex-vivo preservation; Heart transplantation; Ischemia; Primary graft dysfunction; Survival}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{JHLT Open}},
  title        = {{Mid-term follow-up of non-ischemic heart preservation in heart transplantation}},
  url          = {{http://dx.doi.org/10.1016/j.jhlto.2025.100285}},
  doi          = {{10.1016/j.jhlto.2025.100285}},
  volume       = {{9}},
  year         = {{2025}},
}