Controlled temperatures in cold preservation provides safe heart transplantation results

Background We aimed to investigate the short-term outcomes of heart transplant patients who underwent SherpaPak (TM) donor organ preservation. Method We prospectively collected the data of patients who underwent heart transplantation using SherpaPak (TM) system for donor organ transportation from February 2020 to March 2021. Donor and recipient demographic data, preoperative and postoperative echocardiographic and hemodynamic parameters, total ischemic time and SherpaPak temperatures, vasoactive inotropic scores (VIS), primary graft dysfunction (PGD) status, intensive care unit stay, complications, and mortality during follow-up were assessed. Results A total of 39 consecutive heart transplant patients with SherpaPak system were included in the study. The mean donor age was 32.2 +/- 6.7 (range: 16-46). The mean recipient age was 57.5 +/- 12 (range: 19-73). The mean preoperative ejection fraction (EF) was 23.7 +/- 15.4 (range: 5-75). All recipients underwent a standard bicaval technique for orthotopic heart implantation. The mean total ischemic time was 230.1 +/- 41 (range: 149-342) min. The mean Sherpa temperature was 5.6 +/- 0.8 degrees C (range: 3.7-7.5). The mean VIS was 10.2 +/- 6.5 (range: 2-32). The number of mild PGD was 5 (14.7%), and moderate PGD was 4 (11.8%). There was no severe PGD. The postoperative EF was 64.3 +/- 5.5 (range: 50-78). Mean intubation time was 47.4 +/- 64 (range: 8-312, median: 22) h. The mean time of intensive care unit stay was 6.3 +/- 5 (range: 2-31, median: 5) days. Two patients required chest revision (5.8%), two patients had lung infection (5.8%). Two patients had a stroke (5.8%). There was no mortality. Conclusion Using the SherpaPak system during heart transplantation is safe and not associated with significant recipient morbidity. None of the recipients experienced significant PGD and mortality.