Abstract
Purpose Organ Care System (OCS) is a portable platform for ex-vivo warm blood perfusion of donor hearts during preservation. PROCEED is a prospective international multi-center randomized study comparing OCS perfusion to cold storage of donor hearts for transplantation. Early European data strongly suggested that rising lactate level on OCS is a marker of poor heart perfusion on OCS or intrinsic donor heart abnormality. We are reporting on the first prospective analysis of Lactate measurement on OCS during ex-vivo perfusion and correlation with post transplant outcomes. Methods and Materials We are reporting on the first 79 patients enrolled in the PROCEED Trial as of 10/1/12. Thirty-nine (39) patients were randomized to OCS (OCS Group). Three additional hearts were placed on OCS but were not transplanted due to rising lactate levels despite all maneuvers to optimize perfusion (Turn-down Group). The short-term outcome of these hearts were analyzed. Results The starting arterial lactate level (mean ± SD) in the 2 groups were OCS: 2.19 ± 0.85 and turn-down: 2.98 ± 1.4. The mean duration of OCS time was OCS: 221± 73 min, turn-down: 293 ± 118 min. The ending arterial lactate level for OCS group was, 2.3 ± 0.9, whereas the ending arterial lactate level for the turn-down group was 5.3 ± 0.4(p Conclusions During ex-vivo perfusion of the hearts, arterial lactate level is an important marker of donor heart function after implantation. Rising lactate levels during ex-vivo perfusion may be a marker of undetected donor heart abnormality.
Published Version
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