*Purpose: Heart transplantation is an immensely effective service and is currently the only definitive treatment for heart failure. However, transplantation is limited by donor availability. Thoraco-abdominal normothermic regional perfusion (TA-NRP) is an advancement on the classical model of DCD with direct procurement and perfuses the heart in situ after the determination of death and circulatory arrest. This study aims to analyse the outcomes of 59 TANRP cases performed across 3 transplant centres internationally.

*Methods: In this study we analysed the post-transplant outcomes of 59 TA-NRP patients from 3 major transplant centres worldwide; one from each of the UK, the US and Belgium.

*Results: Since the first TA-NRP in 2015 there have been no post-operative deaths and only one intraoperative death due to dissection of the aorta at implantation. The median survival time is 430 days and the mean survival is 800 days. 30 day survival (n=59), 1 year survival (n=39) and 5 year survival (n=10) are all currently at 98.3%. The mean functional warm ischaemic time (FWIT) was 16.8 minutes. The average ICU stay was 7.5 days and mean time spent on a ventilator was 30.3 hours. 9 patients required mechanical support post-operatively. Of these, 7 required an intra-aorta balloon pump, 1 required ECMO and 1 patient required both (n=59). 5 patients required treatment for rejection (n=59).

*Conclusions: The survival rates of TA-NRP are superior to both DBD and conventional direct procurement DCD donors, where the 1-year survival is roughly 90%. The difference may be in part be due to the much shorter periods of warm ischaemic time which minimises both ischaemic and reperfusion injury and prevents the heart from sustaining permanent damage. This, in part, may be mediated by preventing the No-Reflow phenomenon which ensures effective reperfusion of the tissues after ischaemia and effective restoration of cardiac function. Therefore TA-NRP offers an exciting method of organ preservation and procurement. Most importantly of all, it offers a tool with which we can increase the total number of transplants being performed and minimise waiting list mortality. Future work must aim to increase the number of TA-NRPs being performed as well as better understand the mechanisms by which TA-NRP exerts its protective effects.

« Back to 2022 American Transplant Congress