Abstract
Pediatric heart transplantation (HTx) faces challenges such as limited donor availability and the need for complex reconstructions, particularly in patients with congenital anomalies. Ex vivo perfusion offers a promising approach to minimize graft ischemic time and potentially expand the donor pool. We report our single-center experience using the TransMedics Organ Care System (OCS) for ex vivo perfusion in pediatric HTx. From 2020-2024, eight pediatric patients received OCS-perfused donor hearts. Median recipient age was 13 years (range 9-18), and median weight was 58.8 kg (33.2-127.8). Indications for HTx included dilated cardiomyopathy (n=4), hypertrophic cardiomyopathy (n=1), graft vasculopathy (n=1), and Fontan failure (n=2). Median OCS time was 273 minutes (195-328), and recipient ischemic time was 85 minutes (64-139). Post-transplant, all patients had normal LV function at discharge. Over a median follow-up of 11.9 months, there were no deaths. These findings suggest that ex vivo perfusion is a valuable technique in pediatric HTx.
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