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Ex situ heart perfusion: The past, the present, and the future

Lookup NU author(s): Dr Lu Wang, Dr Guy MacGowan, Professor Simi Ali, Professor John Dark

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Abstract

© 2020 International Society for Heart and Lung TransplantationDespite the advancements in medical treatment, mechanical support, and stem cell therapy, heart transplantation remains the most effective treatment for selected patients with advanced heart failure. However, with an increase in heart failure prevalence worldwide, the gap between donor hearts and patients on the transplant waiting list keeps widening. Ex situ machine perfusion has played a key role in augmenting heart transplant activities in recent years by enabling the usage of donation after circulatory death hearts, allowing longer interval between procurement and implantation, and permitting the safe use of some extended-criteria donation after brainstem death hearts. This exciting field is at a hinge point, with 1 commercially available heart perfusion machine, which has been used in hundreds of heart transplantations, and a number of devices being tested in the pre-clinical and Phase 1 clinical trial stage. However, no consensus has been reached over the optimal preservation temperature, perfusate composition, and perfusion parameters. In addition, there is a lack of objective measurement for allograft quality and viability. This review aims to comprehensively summarize the lessons about ex situ heart perfusion as a platform to preserve, assess, and repair donor hearts, which we have learned from the pre-clinical studies and clinical applications, and explore its exciting potential of revolutionizing heart transplantation.


Publication metadata

Author(s): Wang L, MacGowan GA, Ali S, Dark JH

Publication type: Article

Publication status: Published

Journal: Journal of Heart and Lung Transplantation

Year: 2020

Volume: 40

Issue: 1

Pages: 69-86

Online publication date: 13/10/2020

Acceptance date: 02/04/2016

ISSN (print): 1053-2498

ISSN (electronic): 1557-3117

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.healun.2020.10.004

DOI: 10.1016/j.healun.2020.10.004


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