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Selected Publication:
Brodtrager, C.
Depiction of suitable organ preservation methods for orthotopich heart transplantation in regard of duration of cold ischemia and associated post surgical outcome. Focus on the Organ Care System
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2019. pp. 68
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- Authors Med Uni Graz:
- Advisor:
- Dapunt Otto Eugen
- Spiliopoulos Sotirios
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- Abstract:
- Introduction The Organ Care System is a new technology for preservation of organs for heart transplantation through ex vivo perfusion of the beating donor heart with warm, oxygenated, nutrient enriched donor blood. This technology was invented to provide new opportunities relating to long time preservation of the organ, use of donor hearts after circulation death and patient outcome. Methods For the work out of the interrogation the method of literature research was used. The database Pubmeb and specialist books were mainly used for the searching of relevant contents. For the depiction of the latest research findings there was made use of numbers and outcomes of five publications. Results The increasement of creatine kinase MB from pig hearts at preservation with the OCS was notably higher than with preservation through cold ischaemia. When compared to the normal ultrastructure of the heart, the ultrastructure at preservation with the OCS was in a better state than preserved through cold ischaemia in a study with pigs. Moreover, all pigs of a study, which received a donor heart that was preserved with the OCS for 24 hours, presented stable after 24 hours with a normal blood pressure without inotropic support, with a normal production of urine and normal data of blood gases. In a study on humans after heart transplantation, the patient survival and graft survival after 30 days in the der intention-to-treat-population was at 94% in the OCS-group and 97% in the group with classic preservation through cold ischaemia. Statistically a non-inferiority was shown. In another study on humans the overall survival in the OCS-group after 30 days, one year and two years after transplantation was at 96%, 89% and 89%. Compared to that, the overall survival of the organ recipients in the group with classic preservation through cold ischaemia after 30 days, one year and to years was at 95%, 81% and 79%, which is lower than in the other group. In a case series about three organ recipients, who received a donor heart from a donor after circulation death, it was shown, that all three of the patients after several weeks after transplantation were in a good condition. Regarding the costs of material, it was shown, that the costs of the OCS are higher than the costs of preservation through cold ischaemia. Nevertheless, the pre- and postsurgical medical treatment costs can be reduced by use of the OCS. (1–5) Discussion In conclusion, the OCS leads to better results or at least to results which are as good as the ones from the classical preservation through cold ischaemia. Moreover, the OCS brings additional advantage, but consideration hast to be taken about, that the data relating to the survival of the donor heart recipients is still very low.