Coronary computed tomographic angiographic imaging of cardiac allograft preserved in Paragonix SherpaPak Cardiac Transport System

Donation after circulatory death (DCD) heart transplantation is emerging as an alternative pathway to traditional donation after brain death (DBD) to expand the heart donor pool. Greater adoption of DCD heart allografts is hampered by the logistical and ethical constraints to perform invasive antemortem testing, thus limiting the capacity for the standard donor organ quality evaluation. Identification of the absence of coronary artery disease in patients at risk is an essential prerequisite for organ acceptance by an implant institution. This case presents a novel approach to the examination of coronary arteries in a cardiac allograft. We demonstrated that the coronary computed tomographic angiographic imaging of an ex-situ nonbeating cardiac allograft preserved after recovery in SherpaPak Cardiac Transport System is technically feasible. The images are of good quality and allow for three-dimensional reconstruction as well as quantification of coronary lesions.