Cardiac Graft Assessment in the Era of Machine Perfusion: Current and Future Biomarkers

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2021 Feb 1

PMID 33522248

Citations 12

Authors

Martina Bona

Rahel K Wyss

Maria Arnold

Natalia Mendez-Carmona

Maria N Sanz

Dominik Gunsch

Lucio Barile

Thierry P Carrel

Sarah L Longnus

Affiliations

Soon will be listed here.

Abstract

Heart transplantation remains the treatment of reference for patients experiencing end-stage heart failure; unfortunately, graft availability through conventional donation after brain death is insufficient to meet the demand. Use of extended-criteria donors or donation after circulatory death has emerged to increase organ availability; however, clinical protocols require optimization to limit or prevent damage in hearts possessing greater susceptibility to injury than conventional grafts. The emergence of cardiac ex situ machine perfusion not only facilitates the use of extended-criteria donor and donation after circulatory death hearts through the avoidance of potentially damaging ischemia during graft storage and transport, it also opens the door to multiple opportunities for more sensitive monitoring of graft quality. With this review, we aim to bring together the current knowledge of biomarkers that hold particular promise for cardiac graft evaluation to improve precision and reliability in the identification of hearts for transplantation, thereby facilitating the safe increase in graft availability. Information about the utility of potential biomarkers was categorized into 5 themes: (1) functional, (2) metabolic, (3) hormone/prohormone, (4) cellular damage/death, and (5) inflammatory markers. Several promising biomarkers are identified, and recommendations for potential improvements to current clinical protocols are provided.

Citing Articles

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