P130. Outcomes of the novel beating heart method to transition allografts from the Organ Care System (OCS) for implantation: Analysis of OCS Heart Perfusion Registry

Objective:
A novel surgical strategy has been used to transition heart allografts from the OCS Heart device for implantation in a beating, perfused state to avoid the final hypothermic arrest and its associated ischemia-reperfusion injury (IRI). This beating heart transplantation (BHT) surgical technique is now being utilized by an increasing number of centers across the United States. This study aims to describe the technique and examine the outcomes following such strategy.

Methods:
The OCS Heart Perfusion (OHP) Registry was used to identify the transplants where the final flush was bypassed using the novel surgical strategy between Feb-2023 to May-2024. This study used data from the Organ Procurement and Transplantation Network (OPTN) for donor, recipient and transplant data and primary graft dysfunction (PGD) data was collected in the OHP registry. Outcomes including severe primary graft dysfunction (PGD) and survival were compared using the conventional strategy as a benchmark.

Results:
A total of 1278 OCS heart transplants were identified, of which, 4% (55) were performed using the novel BHT surgical technique. This strategy was utilized by 7 different OCS programs. The rate of severe PGD associated with this technique was 6.5%, which was not statistically different than conventional strategy (10.5%; p=0.761). Survival at 6- and 12- months were also similar between the two groups [Figure].

Conclusion:
Early results indicate that this novel surgical strategy is safe and reproducible by multiple centers, without negative impact on outcomes. Continued evaluation is required to examine long-term allograft function and the potential benefits of this technique.

Brandon Guenthart (1), Masashi Kai (2), Lucian Lozonschi (3), Suguru Ohira (4), Ming-Sing Si (5), Chawannuch Ruaengsri (6), Yasuhiro Shudo (7), John MacArthur (8), William Hiesinger (9), Anelechi Anyanwu (10), Y. Joseph Woo (7), (1) Stanford University Medical Center, Stanford, CA, (2) Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, (3) N/A, Madison, WI, (4) Westchester Medical Center, Valhalla, NY, (5) UCLA Mattel Children's Hospital, Calabasas, CA, (6) N/A, Powell, OH, (7) Stanford University, Stanford, CA, (8) Stanford Hospital and Clinics, Menlo Park, CA, (9) Stanford University School of Medicine, STANFORD, CA, (10) Mount Sinai Icahn School of Medicine, New York, NY

Brandon Guenthart

Poster Presenter

Brandon Guenthart is a board-certified, fellowship-trained cardiothoracic surgeon. He is a clinical assistant professor in the Department of Cardiothoracic Surgery at Stanford University. He specializes in providing leading-edge surgical treatment for people with cancer and end-stage heart and lung disease. He performs the full range of surgical procedures ranging from minimally invasive thoracic surgery to heart and lung transplantation and mechanical circulatory support. He directs The Laboratory for Organ Recovery and Bioengineering, a collaborative research group working on expanding the pool of donor organs and developing novel therapeutics to alleviate end-stage heart and lung disease.