An innovative cold storage system for donor heart transportation-lessons learned from the first experience in Switzerland.


Journal

Journal of thoracic disease
ISSN: 2072-1439
Titre abrégé: J Thorac Dis
Pays: China
ID NLM: 101533916

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 16 07 2021
accepted: 22 10 2021
entrez: 24 1 2022
pubmed: 25 1 2022
medline: 25 1 2022
Statut: ppublish

Résumé

The current standard for donor heart preservation consists of cold organ storage in three sequential plastic bags. This technique can cause freezing injuries of the donor heart as the temperature inside the transport box is not monitored routinely. The SherpaPak™ Cardiac Transport System (CTS) (Paragonix Technologies, Cambridge, MA, USA) aims to resolve this problem by maintaining a controlled preservation temperature between 4 and 8 °C. This study reports the first single-centre experience in Switzerland with this innovative single-use disposable device. Between May and December 2020, four heart procurements using SherpaPak™ CTS were performed at our heart centre. Donor heart preservation fluid and ambient temperature were monitored using the InTempConnect Four recipients of a donor heart preserved with SherpaPak™ CTS were included in this study (3 male, 1 female). Mean transport distance was 86 km (range, 45-276 km). Mean storage time in the cooler was 73.5±19.33 minutes. Mean cold ischemic time was 199.25±11.67 minutes. The device kept the average organ temperature between 5.2 and 8.8 °C and hereby reached the recommended temperature range of 5-10 °C. Modifications of the procurement and storage process provided an optimization of the temperature course in the transportation box. There were no incidents during the transport. Organs transported with this novel storage system showed normal function after transplantation. The SherpaPak™ CTS provides constant organ temperatures during transportation, prevents freezing injury and ensures mechanical protection of the graft. Heart transplantation; organ procurement; cold storage; hypothermic injury; graft transport.

Sections du résumé

BACKGROUND BACKGROUND
The current standard for donor heart preservation consists of cold organ storage in three sequential plastic bags. This technique can cause freezing injuries of the donor heart as the temperature inside the transport box is not monitored routinely. The SherpaPak™ Cardiac Transport System (CTS) (Paragonix Technologies, Cambridge, MA, USA) aims to resolve this problem by maintaining a controlled preservation temperature between 4 and 8 °C. This study reports the first single-centre experience in Switzerland with this innovative single-use disposable device.
METHODS METHODS
Between May and December 2020, four heart procurements using SherpaPak™ CTS were performed at our heart centre. Donor heart preservation fluid and ambient temperature were monitored using the InTempConnect
RESULTS RESULTS
Four recipients of a donor heart preserved with SherpaPak™ CTS were included in this study (3 male, 1 female). Mean transport distance was 86 km (range, 45-276 km). Mean storage time in the cooler was 73.5±19.33 minutes. Mean cold ischemic time was 199.25±11.67 minutes. The device kept the average organ temperature between 5.2 and 8.8 °C and hereby reached the recommended temperature range of 5-10 °C. Modifications of the procurement and storage process provided an optimization of the temperature course in the transportation box. There were no incidents during the transport. Organs transported with this novel storage system showed normal function after transplantation.
CONCLUSIONS CONCLUSIONS
The SherpaPak™ CTS provides constant organ temperatures during transportation, prevents freezing injury and ensures mechanical protection of the graft.
KEYWORDS BACKGROUND
Heart transplantation; organ procurement; cold storage; hypothermic injury; graft transport.

Identifiants

pubmed: 35070363
doi: 10.21037/jtd-21-1175
pii: jtd-13-12-6790
pmc: PMC8743396
doi:

Types de publication

Journal Article

Langues

eng

Pagination

6790-6799

Informations de copyright

2021 Journal of Thoracic Disease. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/jtd-21-1175). The authors have no conflicts of interest to declare.

Références

J Heart Lung Transplant. 2020 Jun;39(6):501-517
pubmed: 32503726
J Thorac Cardiovasc Surg. 1989 Oct;98(4):517-22
pubmed: 2796359
Transplant Proc. 2002 Sep;34(6):2320
pubmed: 12270416
Heart Lung Vessel. 2015;7(3):246-55
pubmed: 26495271
Lancet. 2015 Jun 27;385(9987):2577-84
pubmed: 25888086
J Thorac Dis. 2020 Dec;12(12):7227-7235
pubmed: 33447411
Transplant Proc. 1991 Oct;23(5):2445-6
pubmed: 1926424
J Heart Lung Transplant. 1991 Jul-Aug;10(4):518-26
pubmed: 1911794
Ann Thorac Surg. 1999 Nov;68(5):1983-7
pubmed: 10585116
J Thorac Cardiovasc Surg. 2020 Feb;159(2):e121-e123
pubmed: 31420150
J Heart Transplant. 1990 Nov-Dec;9(6):587-93
pubmed: 2277293
J Thorac Cardiovasc Surg. 1982 Jan;83(1):133-40
pubmed: 7033670

Auteurs

Martin O Schmiady (MO)

Clinic for Cardiac Surgery, University Heart Centre, Zurich, Switzerland.

Tim Graf (T)

Clinic for Cardiac Surgery, University Heart Centre, Zurich, Switzerland.

Ahmed Ouda (A)

Clinic for Cardiac Surgery, University Heart Centre, Zurich, Switzerland.

Raed Aser (R)

Clinic for Cardiac Surgery, University Heart Centre, Zurich, Switzerland.

Andreas J Flammer (AJ)

Clinic for Cardiology, University Heart Centre, Zurich, Switzerland.

Paul R Vogt (PR)

Clinic for Cardiac Surgery, University Heart Centre, Zurich, Switzerland.

Markus J Wilhelm (MJ)

Clinic for Cardiac Surgery, University Heart Centre, Zurich, Switzerland.

Classifications MeSH