REVIEW
Transpl. Int.
Volume 38 - 2025 | doi: 10.3389/ti.2025.12987
This article is part of the Special IssueCurrent developments in artificial organs and engineered ex-situ perfused organsView all 14 articles
Ex-vivo heart perfusion machines in DCD heart transplantation model: the state of art Authors
Chiara Tessari1*
Giovanni Lucertini1Mariangela Addonizio1
Veronica Geatti1Daniela Bacich2Nicola Pradegan1Assunta Fabozzo1Roberto Bianco1Giuseppe Toscano1Vincenzo Tarzia1Gino Gerosa1- 1Cardiac Surgery Unit, University Hospital of Padova, Padova, Italy
- 2University Hospital of Padua, Padua, Italy
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Donation-after-Circulatory-Death (DCD) heart transplantation program increases donor pool, but results in more serious ischemic-related myocardial injury (IRI), leading to higher incidence of primary graft dysfunction (PGD). Ex-vivo machine perfusion (EVMP) for DCD heart transplantation is being considered a useful aid in improving grafts number and quality assessment, aiming to better outcomes. In this review we will analyze the role of EVMP techniques in the context of DCD with special attention to their clinical purposes, results, and future perspectives. A review of available clinical and pre-clinical studies involving EVMP with DCD donation model has been performed.Thirty-four original articles about preclinical studies were found. Earlier studies were designed to evaluate graft function in DCD hearts after EVMP, while recent research focuses on possible therapies that could be associated with EVMP. Twenty-one original articles including clinical studies with the Organ-Care-System (TransMedics) as MP were found. Outcomes, such as survival rates or rejection episodes, are comparable to outcomes from donation-after-brain-death.EVMP in the setting of DCD heart transplantation can be a valid tool for organ preservation and transport. The role of pre-clinical research will be crucial to reduce IRI, achieve organ reconditioning and reduce incidence of PGD.
Keywords: heart transplantation, donation after cardiac death, Ischemia and Reperfusion Injury, ex vivo heart perfusion, ex vivo heart preservation
Received: 14 Mar 2024; Accepted: 23 Jul 2025.
Copyright: © 2025 Tessari, Lucertini, Addonizio, Geatti, Bacich, Pradegan, Fabozzo, Bianco, Toscano, Tarzia and Gerosa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chiara Tessari, Cardiac Surgery Unit, University Hospital of Padova, Padova, Italy
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