Extending the boundaries of organ preservation: hope for heart transplantation

The conventional approach to donor heart preservation during transport is static cold storage (SCS). Since the first successful heart transplantation in 1967, cold ischaemic preservation of the donor heart in a crystalloid solution has been the gold standard for myocardial protection. There are potential advantages of HMP over NMP: the cold solution maintains low myocardial metabolism, which might further reduce ischaemic injury when transporting over longer distances; the hypothermic preservation provides increased safety and protection against external factors, such as power failure; and the device requires less surgical and technical support and is less expensive. With additional clinical trials and real-world experience, this technology should widen the donor pool to optimise equitable access to heart transplantation and the quality of life and survival of our patients living with advanced heart failure.