Organ Care System Heart Perfusion (OHP) Registry Annual Report 2024 - Donation After Brain Death (DBD) Donors
Recommended Citation
Kai M, Villavicencio M, Lozonschi L, Ohira S, Williams C, Haft J, Schroder J, Couper G, Malyala R, Pal J, Selzman C, Shudo Y, Daneshmand M, Chan J, Skipper E, Klein L, Gruber P, Ikonomidis J, Esmailian F, Pham D, D'Alessandro D, Patel P, Itoh A, Takeda K, Meyer D, Sun B, Salerno C, Goldstein D, Shah A, Kaczorowski D. Organ Care System Heart Perfusion (OHP) Registry Annual Report 2024 - Donation After Brain Death (DBD) Donors. J Heart Lung Transplant 2025; 44(4):S51.
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
J Heart Lung Transplant
Abstract
Purpose: We report one-year outcomes of donor after brain dead (DBD) hearts procured with the organ care system (OCS) compared to static cold storage (SCS) with data from Organ Procurement and Transplantation Network (OPTN) and Organ Care System Heath Perfusion (OHP) registry. Methods: OHP Registry was created to collect donor and recipient’s characteristics, and post-transplant outcomes for all OCS heart transplant cases in the real-world setting in the US. The DBD donor cohort perfused with the OCS and those transported using SCS were identified using OPTN database during the same time period. Donor, recipient data as well as transplant outcomes were compared. Additionally, utilization rate after OCS perfusion and primary graft dysfunction (PGD) rate was collected for the OCS arm, using the OHP registry. Cohorts were propensity matched on the UNOS status, ventricular assist device (VAD), ventilator support, and recipient diagnosis to evaluate the survival. Results: A total of 549 OCS and 3559 SCS patients were included. Utilization rate on OCS was 97.7% (549/562) after OCS perfusion. The number of donors over the age 40 and 55 were significantly higher in the OCS arm (33.9% vs 25.9% and 4.2% vs 1.7% respectively). The donor to recipient center distance was over twice as long (median 698 miles vs 286; p<0.05) in the OCS arm, with longer total cross-clamp time (mean 414.9 min vs 221.4 min; p<0.05). Donors in the OCS cohort arm were more than twice more likely to be refused prior to acceptance than the SCS arm (median refusal 11 vs 5; p<0.05). The OCS recipients were significantly older (51.8 years old vs 49.4 years old), less dialysis dependent (4.2% vs 7.5%), less status 1 (13.7% vs 20.9%), more status 4 (17.3% vs 13.2%) and more status 1-3 with durable VAD (13.1% vs 8.7%), (p<0.05, respectively). Severe PGD rate was 10.4% in the OCS arm, which captured 80.3% of the whole OCS recipients. When matched 1:1 (549 patients in each), OCS cohort had similar 6-month (90.4% vs 91.3%) and 12-month (89.1% vs 90.7%) survival compared to the SCS cohort (p=0.147). Conclusion: Despite OCS was being utilized for higher risk donors and recipients, the outcomes were similar to SCS. This suggests that the OCS approach can lead to expansion of the donor pool and expansion of recipient access to donors without compromising early outcome.
Volume
44
Issue
4
First Page
S51
