Case Study Report
Courtesy of 12 De Octubre Hospital, Madrid, Spain; Servicio de Cirugia Cardiaca.
“A patient on ECMO and IABP waiting for a new heart”
A Spanish Recovery Team deploying Paragonix SherpaPak™ Cardiac Transport System to Transport a Donor Heart from the Canary Islands to Madrid, Spain
This recent Case Study Report of the Paragonix SherpaPak™ Cardiac Transport System involved a long distance donor heart procurement. The heart transplant recipient was a patient on ECMO and an IABP. Graft function was excellent upon transplantation of the donor heart that was transported using Paragonix SherpaPak™ Cardiac Transport System.
Recipient and Donor Background
The patient, awaiting a heart transplant at the Universitary Hospital 12 de Octubre in Madrid, Spain, is a 58-year-old male with a history of an 8cm ventricular aneurism and heart failure requiring ECMO and an IABP. A male donor was identified in Las Palmas de Gran Canaria, Canary Islands. The donor cause of brain death was a stroke.
Andrea Eixeres, MD, was the procuring surgeon, with José M. Cortina, MD, PhD as the implanting surgeon.
Method of Donor Heart Transport
The Paragonix SherpaPak™ Cardiac Transport System was the chosen method for organ preservation and transport.
The Paragonix SherpaCool™ Ribbons and Pouch were preconditioned in a -20°C freezer for at least 48 hours and maintained under these conditions until the recovery team was ready to depart to the recipient hospital. The small box containing the
Paragonix SherpaCool™ material was transported in an ice chest with an additional 4 liters of preservation solution
submerged under ice.
Donor Heart Recovery
Prior to cross clamp, approximately 3 liters of cold preservation solution were decanted into the organ canister in preparation for the donor heart. The heart was flushed in situ with 1 liter of preservation solution, recovered, and then placed in a basin with slush for inspection and insertion of the heart connector. The heart connector was attached to the aorta using umbilical tape, and from there the process was swift, with ease in assembling the two sterile nested canisters. The canisters were then placed into the shipper for temperature regulation, as well as monitoring and transport.
Transport to Recipient and Preparation of Donor Heart for Implantation
Flight time from Las Palmas de Gran Canaria back to Hospital 12 de Octubre in Madrid was approximately 3 hours.
Transport and Total Ischemic Time
The total time of storage and preservation within the Paragonix SherpaPak™ CTS was 226 minutes with a total ischemic time of 330 minutes. Removal of the donor heart from the shipper and sterile organ canister took less time than removal from the current triple barrier method.
Transport and Temperature Results
The temperatures recorded by Paragonix SherpaPak™ within the preservation solution and right next to the donor heart were within the operating range of 4 – 8°C for optimal preservation and prevention of frostbite and cold damage.
Patient and Graft Outcome
The recipient patient did well without complications coming off bypass and the graft function was excellent. Postoperative
TTE showed normal LV and RV function with 72% of LVEF and RHC showed low normal filing pressures and normal cardiac output.