Long-term outcomes after heart transplantation using ex vivo allograft perfusion in standard risk donors: A single-center experience.

Abstract

The Organ Care System (OCS) is an ex vivo perfusion platform for donor heart preservation. Short/mid-term post-transplant outcomes after its use are comparable to standard cold storage (CS). We evaluated long-term outcomes following its use. Between 2011 and 2013, 38 patients from a single center were randomized as a part of the PROCEED II trial to receive allografts preserved with CS (n=19) or OCS (n=19). Endpoints included 8-year survival, survival free from graft-related deaths, freedom from cardiac allograft vasculopathy (CAV), non-fatal major adverse cardiac events (NF-MACE), and rejections. Eight-year survival was 57.9% in the OCS group and 73.7% in the CS group (p=.24). Freedom from CAV was 89.5% in the OCS group and 67.8% in the CS group (p=.13). Freedom from NF-MACE was 89.5% in the OCS group and 67.5% in the CS group (p=.14). Eight-year survival free from graft-related death was equivalent between the two groups (84.2%vs. 84.2%, p=.93). No differences in rejection episodes were observed (all p>.5). In select patients receiving OCS preserved allografts, late post-transplant survival trended lower than those transplanted with an allograft preserved with CS. This is based on a small single-center series, and larger numbers are needed to confirm these findings.