Out of the ice age: Preservation of cardiac allografts with a reusable 10 °C cooler
John M. Trahanas, Timothy Harris, Mark Petrovic, Anthony Dreher, Chetan Pasrija, Stephen A DeVries, Swaroop Bommareddi, Brian Lima, Chen Chia Wang, Michael Cortelli, Avery Fortier, Kaitlyn Tracy, Elizabeth Simonds, Clifton D Keck, Shelley R Scholl, Hasan K. Siddiqi, Kelly Schlendorf, Matthew Bacchetta, Ashish S. Shah
Abstract
Objective: Static cold storage with ice has been the mainstay of cardiac donor preservation. Early preclinical data suggest that allograft preservation at 10 °C may be beneficial. We tested this hypothesis by using a static 10 °C storage device to preserve and transport cardiac allografts. Methods: In total, 52 allografts were recovered between July 2023 and March 2024 and transported using a 10 °C storage cooler. Results were compared to a 3:1 propensity match of allografts transported on ice. Patients were excluded for the following reasons: dual viscera transplant, previous heart transplant, complex congenital heart disease, or allograft injury during procurement. Results: > .99). 10 °C hearts demonstrated less change in lactate but no difference in vasoactive inotrope scores or cardiac index. In hearts with extended ischemic time, delta lactate was lower in 10 °C cooler hearts. There was no statistical difference in outcomes for donor hearts >40 years old. Conclusions: This is an early experience of static preservation in a 10 °C cooler. Postoperative allograft function was excellent, and lactate profiles lower in those allografts with extended ischemic times. Static cold storage targeting 10 °C may offer an inexpensive method for extended heart preservation. Further investigation is needed to assess long-term outcomes of 10 °C storage.