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Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry.

Publication ,  Journal Article
Moayedifar, R; Shudo, Y; Kawabori, M; Silvestry, S; Schroder, J; Meyer, DM; Jacobs, JP; D'Alessandro, D; Zuckermann, A
Published in: J Heart Lung Transplant
April 2024

BACKGROUND: The prevalence of end-stage heart failure and patients who could benefit from heart transplantation requires an expansion of the donor pool, relying on the transplant community to continually re-evaluate and expand the use of extended criteria donor organs. Introduction of new technologies such as the Paragonix SherpaPak Cardiac Transport System aids in this shift. We seek to analyze the impact of the SherpaPak system on recipient outcomes who receive extended criteria organs in the GUARDIAN-Heart Registry. METHODS: Between October 2015 and December 2022, 1,113 adults from 15 US centers receiving donor hearts utilizing either SherpaPak (n = 560) or conventional ice storage (ice, n = 453) were analyzed from the GUARDIAN-Heart Registry using summary statistics. A previously published set of criteria was used to identify extended criteria donors, which included 193 SherpaPak and 137 ice. RESULTS: There were a few baseline differences among recipients in the 2 cohorts; most notably, IMPACT scores, distance traveled, and total ischemic time were significantly greater in SherpaPak, and significantly more donor hearts in the SherpaPak cohort had >4 hours total ischemia time. Posttransplant mechanical circulatory support utilization (SherpaPak 22.3% vs ice 35.0%, p = 0.012) and new extracorporeal membrane oxygenation/ventricular assist device (SherpaPak 7.8% vs ice 15.3%, p = 0.033) was significantly reduced, and the rate of severe primary graft dysfunction (SherpaPak 6.2% vs ice 13.9%, p = 0.022) was significantly reduced by over 50% in hearts preserved using SherpaPak. One-year survival between cohorts was similar (SherpaPak 92.9% vs ice 89.6%, p = 0.27). CONCLUSIONS: This subgroup analysis demonstrates that SherpaPak can be safely used to utilize extended criteria donors with low severe PGD rates.

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Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

April 2024

Volume

43

Issue

4

Start / End Page

673 / 680

Location

United States

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Registries
  • Ice
  • Humans
  • Heart Transplantation
  • Heart
  • Adult
  • 3202 Clinical sciences
 

Citation

APA
Chicago
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MLA
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Moayedifar, R., Shudo, Y., Kawabori, M., Silvestry, S., Schroder, J., Meyer, D. M., … Zuckermann, A. (2024). Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry. J Heart Lung Transplant, 43(4), 673–680. https://doi.org/10.1016/j.healun.2023.12.013
Moayedifar, Roxana, Yasuhiro Shudo, Masashi Kawabori, Scott Silvestry, Jacob Schroder, Dan M. Meyer, Jeffrey P. Jacobs, David D’Alessandro, and Andreas Zuckermann. “Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry.J Heart Lung Transplant 43, no. 4 (April 2024): 673–80. https://doi.org/10.1016/j.healun.2023.12.013.
Moayedifar R, Shudo Y, Kawabori M, Silvestry S, Schroder J, Meyer DM, et al. Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry. J Heart Lung Transplant. 2024 Apr;43(4):673–80.
Moayedifar, Roxana, et al. “Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry.J Heart Lung Transplant, vol. 43, no. 4, Apr. 2024, pp. 673–80. Pubmed, doi:10.1016/j.healun.2023.12.013.
Moayedifar R, Shudo Y, Kawabori M, Silvestry S, Schroder J, Meyer DM, Jacobs JP, D’Alessandro D, Zuckermann A. Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry. J Heart Lung Transplant. 2024 Apr;43(4):673–680.
Journal cover image

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

April 2024

Volume

43

Issue

4

Start / End Page

673 / 680

Location

United States

Related Subject Headings

  • Tissue Donors
  • Surgery
  • Retrospective Studies
  • Registries
  • Ice
  • Humans
  • Heart Transplantation
  • Heart
  • Adult
  • 3202 Clinical sciences