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<p>For organ removal and transport in the context of heart transplantation several different systems and methods are currently available. The hypothermic transport of cardioplegic hearts certainly represents the most widely spread method by far. Ultimately, this approach has been the standard worldwide since the 1980s and the introduction of the definition of brain death, i.e., completely controlled removal of the heart. The results of this removal and transport technique are very good and reproducible for decades; however, it must be emphasized that there is still a critical limit for this technique for the ischemia time of the organ of approximately 4–5 h. The new preservation and transport strategies should permit prolonged ischemic times with comparable results for the recipient as proven in different studies; however, it is always important to differentiate between hypothermic transport with the current modifications (SherpaPak, Vitalpak) and the so-called mechanical perfusion (OCS, XVIVO). A relevant criterion for the selection of the suitable system is certainly the cost of a&#xa0;mission and especially in Germany, the coverage by the health insurance. The currently used routine technique of hypothermic transport in a polystyrene box after cardioplegia is completely covered by health insurances whereas the much higher costs of the other systems have so far only been covered within the framework of studies or by the user. This problem (cost 10,000–65,000 € per mission depending on the system) represents an absolute limitation for further and extended use of these innovative devices.</p>

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Neue Perfusions- und Konservierungstechniken im Rahmen der Herztransplantation

  • 期刊论文

  • 发表日期：

    2025年8月29日

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  • U. Boeken,
  • V. Hettlich,
  • H. Aubin,
  • M. Scherner,
  • B. Ramadani,
  • A. Lichtenberg

摘要

For organ removal and transport in the context of heart transplantation several different systems and methods are currently available. The hypothermic transport of cardioplegic hearts certainly represents the most widely spread method by far. Ultimately, this approach has been the standard worldwide since the 1980s and the introduction of the definition of brain death, i.e., completely controlled removal of the heart. The results of this removal and transport technique are very good and reproducible for decades; however, it must be emphasized that there is still a critical limit for this technique for the ischemia time of the organ of approximately 4–5 h. The new preservation and transport strategies should permit prolonged ischemic times with comparable results for the recipient as proven in different studies; however, it is always important to differentiate between hypothermic transport with the current modifications (SherpaPak, Vitalpak) and the so-called mechanical perfusion (OCS, XVIVO). A relevant criterion for the selection of the suitable system is certainly the cost of a mission and especially in Germany, the coverage by the health insurance. The currently used routine technique of hypothermic transport in a polystyrene box after cardioplegia is completely covered by health insurances whereas the much higher costs of the other systems have so far only been covered within the framework of studies or by the user. This problem (cost 10,000–65,000 € per mission depending on the system) represents an absolute limitation for further and extended use of these innovative devices.