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Review
. 2025 Apr;44(4):672-680.
doi: 10.1016/j.healun.2024.12.001. Epub 2024 Dec 25.

Current approaches to optimize the donor heart for transplantation

Amit H Alam  1 , Candice Y Lee  2 , Manreet K Kanwar  3 , Yasbanoo Moayedi  4 , Alexander M Bernhardt  5 , Koji Takeda  6 , Duc Thinh Pham  7 , Christopher Salerno  8 , Andreas Zuckermann  9 , David D'Alessandro  10 , Victor G Pretorius  11 , John O Louca  12 , Stephen Large  13 , Dawn E Bowles  14 , Scott C Silvestry  15 , Nader Moazami  16
Affiliations
Review

Current approaches to optimize the donor heart for transplantation

Amit H Alam et al. J Heart Lung Transplant. 2025 Apr.

Abstract

Heart transplantation remains a critical therapy for patients with end-stage heart failure, offering incremental survival and improved quality of life. One of the key components behind the success of heart transplantation is the condition and preservation of the donor's heart. In this review, we provide a comprehensive overview of ischemic reperfusion injury, risk factors associated with primary graft dysfunction, current use of various preservation solutions for organ procurement, and recent advancements in donor heart procurement technologies. This state-of-the-art review will explore factors associated with bringing the "ideal" donor heart to the operating room in the contemporary era.

Keywords: heart preservation system; ischemic reperfusion injury; organ preservation; organ procurement; primary graft dysfunction; sherpaPak; transmedics.

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Conflict of interest statement

Disclosure statement Dr M.K. reports relationships with Abbott, Abiomed, and BiVACOR. Dr A.B. reports relationships with Abbott, Abiomed, and International Society for Heart and Lung Transplantation. Dr D.A. reports relationships with Abiomed and Paragonix. Dr A.Z. is a speaker for Paragonix. All other authors with no disclosures relevant to this manuscript. We would like to thank Sabrina Taylor from the University College London Medical School for her assistance in appropriately formatting the references. We would also thank Dr Peter MacDonald of the Victor Chang Cardiac Research Institute for his permission in allowing us to use Figure 2 for our manuscript. Funding: None.

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