Cardiac transport system linked to better outcomes after heart transplantation
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A cardiac transport system for donor hearts was associated with better 1-year outcomes for recipients compared with traditional cold storage, according to new data from the GUARDIAN registry.
The analysis, presented at the International Society for Heart and Lung Transplantation Annual Meeting and Scientific Sessions, compared survival and other postoperative outcomes in heart transplant recipients who received a heart delivered with the cardiac transport system (SherpaPak cardiac transport system, Paragonix Technologies) with those whose hearts were delivered in traditional cold storage. The cohort included 569 adult patients who received their hearts from October 2015 to January 2022; those who received the cardiac transport system and those who received cold storage were matched based on propensity scores.
The rate of survival at 1 year was 96.4% in the cardiac transport system group compared with 88.7% in the cold storage group (difference, 7.7 percentage points; P = .03), Marzia Leacche, MD, Richard DeVos Endowed Chair for Heart Transplant and Mechanical Circulatory Support and surgical director at Spectrum Health in Michigan, said during a presentation.
The cardiac transport system was also associated with a 71.9% reduction in rates of severe primary graft dysfunction (3% vs. 12%; P = .005), a 38.5% reduction in posttransplant mechanical circulatory support (P = .03), a 66.3% reduction in use of extracorporeal membrane oxygenation or a ventricular assist device (P = .02) and a 59.7% reduction in newly placed intra-aortic balloon pumps (P = .02) compared with traditional cold storage, according to the researchers.
“Innovations in patient care are rarely this impactful,” Leacche said in a press release. “We hypothesize that the survival benefit is due to reduction in the incidence of severe primary graft dysfunction and reduced need for mechanical circulatory support after transplant.”
“The results of this study suggest that using ice to preserve and transport donor hearts is a potentially inferior method for organ preservation,” Andreas Zuckermann, MD, director of cardiac transplantation and associate professor of surgery at Medical University of Vienna and the EU principal investigator for the GUARDIAN registry, said in the release. “A 96.4% 1-year survival rate in the propensity-matched analysis utilizing the SherpaPak is an encouraging sign that this technology for advanced organ preservation is having an impact on the clinical outcomes of heart transplantation. Advanced preservation of donor hearts should be a seriously considered by all transplant centers when assessing the impact on clinical outcomes outlined in this research.”
Reference:
- Paragonix Technologies SherpaPak improves 1-year survival in heart transplant patients in real-world study. paragonixtechnologies.com/paragonix-technologies-sherpapak-improves-1-year-survival-in-heart-transplant-patients-in-real-world-study. Published April 27, 2022. Accessed May 6, 2022.
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Leacche M, et al. Take a Chance With Me: Extended Criteria Transplants and Risk Modeling in Heart Transplant. Presented at: International Society for Heart and Lung Transplantation Annual Meeting and Scientific Sessions; April 27-30, 2022; Boston (hybrid meeting).
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