Diana Garcia Saez
Initial Experience with the
Organ Care System Heart
Diana García Sáez, Bartlomiej Zych, Fabio De Robertis, Olaf Maunz, Louise Mc Brearty, Prashant Mohite, Anton Sabashnikov,
Chris Bowles, Rachel Hards, Nicky Crouchen, Mohamed Amrani, Toufan Bahrami, Nick Banner, Andre R Simon
Department of Cardiothoracic Transplantation & Mechanical Circulatory Support,
Harefield Hospital, London
Introduction
Severe shortage of available donor organs
Increasing attempts to utilize marginal organs
This may result in higher risk organ-recipient combinations
Organ Care System Heart (OCS)
Preservation and transport of a continuously perfused heart at 34°C
Extended out of body times
Avoids the negative effect of cold ischemic storage
Additional assessment options
PROCEED Trial is an international, FDA pivotal trial to assess the clinical efficacy
and safety of the OCS
Heart technology for heart transplantation.
12 patients transplanted with the Organ Care System Heart at Harefield Hospital
1.
2.
At Donor site
A.
Donor management; Weaning inotropes, Hematocrit > 30%
B.
Donor blood collection (1500 ml) inmediately before aortic X Clamp
C.
Heart cannulation and instrumentation to OCS
Heart management and assessment on OCS:
A.
Perfusion parameters (Aortic Pressure- AOP , Coronary flow-CF)
B.
Lactate: Venous < Arterial << 5 mmol/L and Lactate decreasing over time indicate
good myocardial perfusion
AORTIC
CANNULATION
PULMONARY ARTERY
CANNULATION
Conclusions
The Organ Care System increases the donor pool;
Utilizing organs previously not considered for transplantation (marginal
donors, prolonged transport time)
Transplanting higher risk recipients (VADs, Pulmonary hypertension)
Cold ischemic time reduced to 100 minutes
The observed mortality and morbidity was more favorable than expected given
the combined risk profile donor-recipient
OCS preservation may become the standard of care in these situations
Initial Experience with the
Organ Care System Heart
Diana García Sáez, Bartlomiej Zych, Fabio De Robertis, Olaf Maunz, Louise Mc Brearty, Prashant Mohite, Anton Sabashnikov,
Chris Bowles, Rachel Hards, Nicky Crouchen, Mohamed Amrani, Toufan Bahrami, Nick Banner, Andre R Simon
Department of Cardiothoracic Transplantation & Mechanical Circulatory Support,
Harefield Hospital, London