Donor Heart Preservation at 4-8°C Using Moderate Hypothermic Donor Heart Preservation Improves 4-year Survival in the US Guardian-Heart Registry

Authors

• D D'Alessandro
• Y Shudo
• M Rodrigo
• S Pham
• K Takeda
• Renzo Loyaga-Rendon, Corewell Health West
• C Sciortino
• J Schroder
• A Zeeshan
• J Jacobs

Document Type

Conference Proceeding

Publication Date

4-2025

Publication Title

Journal of Heart and Lung Transplantation

Abstract

Purpose: Static controlled hypothermic donor heart transportation (SCTS) is frequently used to preserve donor organs, utilized in almost 50% of US transplants in 2023. We now report follow-up through 4-years of post-transplant survival data comparing SCTS to historic transport using ice.

Methods: We analyzed the GUARDIAN-heart registry including 1,347 adults at 20 transplant centers in the US, comparing 4-year mortality rates between transplants utilizing the SCTS (N = 742) or conventional ice storage (N = 605). Propensity matching was conducted on variables of site, total ischemic time, donor age, baseline durable Left ventricular assist device (LVAD), and extracorporeal membrane oxygenation (ECMO).

Results: The SCTS cohort had significantly less severe primary graft dysfunction (PGD) and severe right ventricular dysfunction (RVD) compared to ice in the unmatched cohort, despite significantly longer ischemic times (Table). Following propensity matching to minimize potential confounders, SCTS had significantly lower severe PGD by 36% (p=0.035) and severe RVD by 44% (p=0.013). Survival was significantly greater through 4 years in SCTS (87% vs 85%, p=0.042, Figure), specifically due to significantly greater freedom from cardiovascular-related mortality (p=0.014). Further analysis with ongoing enrollment through January 2025 will be available for presentation.

Conclusion: Utilization of the SCTS for organ preservation is associated with significant improvements in post-transplant outcomes, including a statistically significant survival advantage through 4 years.

Volume

44

Issue

4 Suppl

First Page

s51

Comments

International Society for Heart and Lung Transplantation (ISHLT) 45th Annual Meeting, April 27-30, 2025, Boston, MA

Last Page

s52

Recommended Citation

D'Alessandro D, Shudo Y, Rodrigo M, Pham S, Takeda K, Loyaga-Rendon R, et al. Donor heart preservation at 4-8°C using moderate hypothermic donor heart preservation improves 4-year survival in the US GUARDIAN-Heart Registry. J Heart Lung Transplant. 2025;44(4 Suppl):S51-S2. doi: 10.1016/j.healun.2025.02.108.

DOI

10.1016/j.healun.2025.02.108

ISSN

1053-2498