Gregory Vasiliki, Isath Ameesh, Lanier Gregg M, Levine Avi, Pan Stephen, Aggarwal-Gupta Chhaya, Elgar Guy, Shimamura Junichi, Wolfe Kevin, Gass Alan, Spielvogel David, Kai Masashi, Ohira Suguru
New York Medical College, Valhalla, New York, USA.
Department of Cardiology, Westchester Medical Center, Valhalla, New York, USA.
Artif Organs. 2025 Jan;49(1):119-128. doi: 10.1111/aor.14855. Epub 2024 Sep 6.
The Organ Care System (OCS) (Transmedics, Andover, MA) reduces cold ischemic time of donor hearts by producing a normothermic beating state during ex vivo perfusion, enabling extended ex situ intervals, which potentially increases donor pool. We aimed to compare outcomes in utilization of OCS and conventional cold storage technique.
Consecutive heart transplants following brain death at our institution between May 2022 and July 2023 were analyzed. Recipients were divided into those receiving hearts preserved with OCS [N = 15] and those with conventional cold storage (Control, N = 27), with OCS utilization when anticipated ischemic time was more than 4 h. Pre-transplant characteristics and transplant outcomes were compared.
OCS utilization allowed a significant increase in distance traveled for heart retrieval (OCS, 624 ± 269 vs. Control, 153 ± 128 miles, p < 0.001), with longer mean total preservation times (6.2 ± 1.1 vs 2.6 ± 0.6 h, p < 0.001). All but one patient displayed a general decrease or plateau in lactate throughout perfusion time by OCS. Both groups experienced similar rates of severe primary graft dysfunction (OCS, 6.7% [N = 1] vs. Control, 11.1% [N = 3], p = 0.63), with 100% in-hospital survival in the OCS group compared to 96.3% in the Control group (p = 0.34). Kaplan-Meier survival analysis showed that estimated one-year survival were comparable (OCS, 93.3 ± 6.4% vs. Control, 88.9 ± 6.0%, p = 0.61).
With a mean preservation time of around 6 h and distance covered of over 600 miles, our results using OCS indicate a potential to safely increase the quantity and viability of accessible organs, thus broadening the donor pool without negatively affecting outcomes.
器官护理系统（OCS）（Transmedics公司，马萨诸塞州安多弗）通过在体外灌注期间产生常温搏动状态来减少供心的冷缺血时间，从而延长体外保存时间，这有可能增加供体库。我们旨在比较OCS和传统冷藏技术的使用效果。
分析了2022年5月至2023年7月在本机构连续进行的脑死亡后心脏移植病例。接受者被分为接受OCS保存心脏的患者（N = 15）和接受传统冷藏的患者（对照组，N = 27），当预期缺血时间超过4小时时使用OCS。比较移植前特征和移植结果。
使用OCS显著增加了心脏获取的运输距离（OCS组为624±269英里，对照组为153±128英里，p < 0.001），平均总保存时间更长（6.2±1.1小时对2.6±0.6小时，p < 0.001）。除一名患者外，所有接受OCS灌注的患者在整个灌注时间内乳酸水平普遍下降或趋于平稳。两组严重原发性移植物功能障碍的发生率相似（OCS组为6.7%[N = 1]，对照组为11.1%[N = 3]，p = 0.63），OCS组的院内生存率为100%，对照组为96.3%（p = 0.34）。Kaplan-Meier生存分析显示，估计的一年生存率相当（OCS组为93.3±6.4%，对照组为88.9±6.0%，p = 0.61）。
我们使用OCS的结果显示，平均保存时间约为6小时，运输距离超过600英里，这表明有可能安全地增加可获取器官的数量和活力，从而扩大供体库，且不会对结果产生负面影响。
