ReviewContinuous donor perfusion for heart preservation

One of the keys to successful cardiac transplantation is preservation of the heart during explantation, transport and implantation. To date the most commonly used method has been cold static storage and this currently remains the only method available for pediatric recipients. However, there has long been interest in continuous perfusion of the donor organ during the ex vivo period to mitigate the effects of ischemia and this is now becoming a clinical reality for adult recipients with good short and early midterm results. Data to date however suggests that the greatest benefit lies in preserving marginal organs, especially those following circulatory death, or when a prolonged ischemic time can be predicted.