Transport system confers fewer heart transplant complications vs. ice storage
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Key takeaways:
- A cardiac transport system was linked to fewer complications vs. ice transport in extended-criteria heart transplant recipients.
- Survival rates at 1 year were similar between the groups.
A cardiac transport system for donor hearts was associated with fewer complications than conventional ice storage in patients receiving extended-criteria donor hearts, researchers reported in the Journal of Heart and Lung Transplantation.
The researchers analyzed adults from nine U.S. centers from the GUARDIAN Heart Registry who received a transplant from October 2015 to December 2022 of a heart that was delivered in the cardiac transport system (SherpaPak, Paragonix Technologies) or conventional ice storage. For the present analysis, the researchers included 193 patients from the SheraPak group and 137 from the ice group who received extended-criteria donor hearts. The extended criteria include hearts with more than 4 hours of total ischemic time or hearts with more than 2 hours of total ischemic time with at least one of the following characteristics: donor age older than 55 years, more than 20 minutes of downtime, donor left ventricular ejection fraction of 40% to 50%, LV posterior wall thickness of 12 mm to 16 mm or luminal irregularities.
Data were derived from Moayedifar R, et al. J Heart Lung Transpl. 2023;doi:10.1016/j.healun.2023.12.013.
The results were consistent with an interim analysis presented in April at the International Society for Heart & Lung Transplantation Annual Meeting & Scientific Sessions.
“Heart transplantation remains the gold-standard treatment for patients with end-stage heart failure,” Andreas Zuckermann, MD, director for cardiac transplantation at the Medical University of Vienna, and colleagues wrote. “Over the past decade, heart transplants in the United States increased by 67.4%; however, a record 4,373 new patients were added to the waiting list in 2021, resulting in a waitlist exceeding 7,000 patients, highlighting a shortage of donor hearts. Nevertheless, recipient centers often decline donor hearts that do not meet stringent acceptance criteria. Consequently, the possibility to safely utilize extended-criteria donor hearts to expand the donor pool is an area of immediate and growing interest.”
Compared with the ice group, the SherpaPak group had greater IMPACT scores, distance traveled and total ischemic time, and the hearts in the SherpaPak group were more likely to have more than 4 hours of ischemic time (67.9% vs. 46.7%; P < .001), according to the researchers.
The following outcomes occurred less often in the SherpaPak group than in the ice group: posttransplant mechanical circulatory support use (22.3% vs. 35%; P = .012), new extracorporeal membrane oxygenation or ventricular assist device (7.8% vs. 15.3%; P = .033) and severe primary graft dysfunction (6.2% vs. 13.9%; P = .022).
At 1 year, survival rates were similar between the groups (SherpaPak, 92.9%; ice, 89.6%; P = .27), the researchers wrote.
“The study finds the Paragonix SherpaPak Cardiac Transport System provides a clinically effective solution to safely increase donor heart utilization. The results provide strong support for the utilization of Paragonix advanced organ preservation technologies with extended-criteria donor organs,” Zuckermann said in a press release. “These findings demonstrate that the SherpaPak can be safely utilized to expand the donor pool to keep pace with the demand for heart transplants.”
Reference:
- Paragonix SherpaPax recognized for maximizing access to the donor pool in new clinical study. https://www.paragonixtechnologies.com/news/paragonix-sherpapak-recognized-for-maximizing-access-to-the-donor-pool-in-new-clinical-study. Published Jan. 9, 2024. Accessed Jan. 17, 2024.
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