National Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan.
Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
J Cardiothorac Surg. 2020 Oct 27;15(1):323. doi: 10.1186/s13019-020-01367-w.
Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS).
Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n = 25) versus standard cold storage (n = 10) were included in this study.
During this period, 353 patients were implanted with left ventricular assisted device (LVAD) and 35 (10%) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p = 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p = 0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p = 0.002). All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p = 0.5).
Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support.
器官保存系统（OCS）可最大程度地减少冷缺血时间，并优化物流和精细的受体准备。与低温保存（CS）相比，使用 OCS 进行常温体外保存对长时间心脏保存的影响特别有利于通过机械循环支持（MCS）桥接进行移植的高危受体。
在 2012 年至 2018 年期间，我们对前瞻性收集的数据进行了回顾性单中心研究。本研究纳入了使用 OCS 心脏（n=25）与标准低温保存（n=10）进行心脏移植并接受 MCS 治疗的所有患者。
在此期间，有 353 例患者植入左心室辅助装置（LVAD），其中 35 例（10%）桥接进行心脏移植。供体和受体特征以及危险因素无显著差异。心脏移植后死亡率预测指数（IMPACT）评分显示 OCS 组 1 年死亡风险估计较高（14.2%对 10.8%，p=0.083）。CS 组与 OCS 组在保存过程中的总缺血时间明显较长（210（23）对 74.6（13）分钟，p=0.001）。OCS 中体外常温心脏灌注时间的中位数为 348.4（132；955）分钟。OCS 组和 CS 组之间的体外时间差异有统计学意义，分别为 423（67）分钟和 210（23）分钟，p=0.002。CS 组所有患者在植入后第 30 天存活，而 OCS 组有 96%存活（p=0.5）。
与低温储存相比，使用器官保存系统在运输过程中对供体进行常温体外保存可能有利于长时间体外器官保存，特别是对于接受机械循环支持的受体。
