| Abstract [eng] |
Heart failure affects millions globally, with many patients on waiting lists for transplantation facing long delays and high mortality rates. The limited availability of suitable donor hearts, coupled with prolonged ischemic times during transport, poses significant challenges. However, the availability of donor hearts limits the number of transplantations, particularly in geographically large countries like Kazakhstan, where donor organs often need to be transported over long distances. Ex-situ heart perfusion (ESHP) technologies allow for prolonged donor heart preservation, providing a platform to maintain metabolic activity and potentially improve graft viability. The aim of my study was to evaluate the efficiency of preserving a donor heart using blood cardioplegia and conditioning in an ex-situ donor heart perfusion period, and to compare normothermic ex-situ preservation using an organ care system with cold storage of donor hearts in patients who undergo heart transplantation with left ventricle assist devices. In adition, we evaluated the impact of the treatment of beating heart in normothermic ex situ heart perfusion based on ECMO technology (homemade) on post-transplant graft function. Our prospective, randomized, controlled study included adult patients with end-stage heart failure undergoing transplantation. Donor hearts were preserved using the Organ Care System (OCS). The findings demonstrate that blood cardioplegia combined with myocardial conditioning during normothermic ESHP is a safe and effective strategy for donor heart preservation. This method reduces ischemia-reperfusion injury, inflammatory responses, and metabolic disturbances during prolonged donor heart transport. |
