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Machine Perfusion for Human Heart Preservation : A Systematic Review

Qin, Guangqi ; Jernryd, Victoria LU ; Sjöberg, Trygve LU ; Steen, Stig LU and Nilsson, Johan LU orcid (2022) In Transplant International 35.
Abstract

Currently, static cold storage (SCS) of hearts from donations after brainstem death remains the standard clinically. However, machine perfusion (MP) is considered an approach for donor organ management to extend the donor pool and/or increase the utilization rate. This review summarizes and critically assesses the available clinical data on MP in heart transplantation. We searched Medline (PubMed), Cochrane, Embase, and clinicaltrials.gov, along with reference lists of the included publications and identified 40 publications, including 18 articles, 17 conference abstracts, and five ongoing clinical trials. Two types of MP were used: hypothermic MP (HMP) and normothermic MP (NMP). Three studies evaluated HMP, and 32 evaluated NMP.... (More)

Currently, static cold storage (SCS) of hearts from donations after brainstem death remains the standard clinically. However, machine perfusion (MP) is considered an approach for donor organ management to extend the donor pool and/or increase the utilization rate. This review summarizes and critically assesses the available clinical data on MP in heart transplantation. We searched Medline (PubMed), Cochrane, Embase, and clinicaltrials.gov, along with reference lists of the included publications and identified 40 publications, including 18 articles, 17 conference abstracts, and five ongoing clinical trials. Two types of MP were used: hypothermic MP (HMP) and normothermic MP (NMP). Three studies evaluated HMP, and 32 evaluated NMP. Independent of the system, MP resulted in clinical outcomes comparable to traditional SCS. However, NMP seemed especially beneficial for high-risk cases and donation after circulatory death (DCD) hearts. Based on currently available data, MP is non-inferior to standard SCS. Additionally, single-centre studies suggest that NMP could preserve the hearts from donors outside standard acceptability criteria and DCD hearts with comparable results to SCS. Finally, HMP is theoretically safer and simpler to use than NMP. If a machine malfunction or user error occurs, NMP, which perfuses a beating heart, would have a narrower margin of safety. However, further well-designed studies need to be conducted to draw clear conclusions.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
donor, heart preservation, heart transplantation, machine perfusion, review
in
Transplant International
volume
35
article number
10258
publisher
Springer
external identifiers
  • scopus:85127982574
  • pmid:35401041
ISSN
0934-0874
DOI
10.3389/ti.2022.10258
language
English
LU publication?
yes
id
6b6706a5-ef3f-49e7-8031-6cbc96a2e27f
date added to LUP
2022-06-10 10:57:41
date last changed
2024-06-14 20:14:31
@article{6b6706a5-ef3f-49e7-8031-6cbc96a2e27f,
  abstract     = {{<p>Currently, static cold storage (SCS) of hearts from donations after brainstem death remains the standard clinically. However, machine perfusion (MP) is considered an approach for donor organ management to extend the donor pool and/or increase the utilization rate. This review summarizes and critically assesses the available clinical data on MP in heart transplantation. We searched Medline (PubMed), Cochrane, Embase, and clinicaltrials.gov, along with reference lists of the included publications and identified 40 publications, including 18 articles, 17 conference abstracts, and five ongoing clinical trials. Two types of MP were used: hypothermic MP (HMP) and normothermic MP (NMP). Three studies evaluated HMP, and 32 evaluated NMP. Independent of the system, MP resulted in clinical outcomes comparable to traditional SCS. However, NMP seemed especially beneficial for high-risk cases and donation after circulatory death (DCD) hearts. Based on currently available data, MP is non-inferior to standard SCS. Additionally, single-centre studies suggest that NMP could preserve the hearts from donors outside standard acceptability criteria and DCD hearts with comparable results to SCS. Finally, HMP is theoretically safer and simpler to use than NMP. If a machine malfunction or user error occurs, NMP, which perfuses a beating heart, would have a narrower margin of safety. However, further well-designed studies need to be conducted to draw clear conclusions.</p>}},
  author       = {{Qin, Guangqi and Jernryd, Victoria and Sjöberg, Trygve and Steen, Stig and Nilsson, Johan}},
  issn         = {{0934-0874}},
  keywords     = {{donor; heart preservation; heart transplantation; machine perfusion; review}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Springer}},
  series       = {{Transplant International}},
  title        = {{Machine Perfusion for Human Heart Preservation : A Systematic Review}},
  url          = {{http://dx.doi.org/10.3389/ti.2022.10258}},
  doi          = {{10.3389/ti.2022.10258}},
  volume       = {{35}},
  year         = {{2022}},
}