Twenty-Hour Hypothermic Oxygenated Perfusion Preserves Myocardial Viability and Bioenergetics with No Primary Graft Dysfunction After Porcine Heart Transplantation

Twenty hours of hypothermic oxygenated perfusion (HOPE) in porcine donor hearts preserves myocardial viability and bioenergetics, with no primary graft dysfunction after transplantation.

• Why it matters: Conventional cold storage limits donor preservation time, and it is unclear whether longer HOPE maintains early graft function and cellular metabolic integrity after heart transplantation.
• What they did: Ten porcine donor hearts were preserved by static cold storage for 4 hours (n=2), HOPE for 4 hours (n=3), or HOPE for 20 hours (n=5), then transplanted into recipient pigs; graft function was tracked for 3 hours and myocardium assessed by histology, flow cytometry, mitochondrial respirometry, transcriptomics, and proteomics.
• The result: Ejection fraction, right atrial pressure, systolic blood pressure, and vasoactive support were similar across groups, and no graft met primary graft dysfunction criteria; maximal oxygen consumption rate was higher in HOPE 20h, with limited transcriptomic/proteomic differences.

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