ArticleJournal of the American Heart Association2026
Ex Vivo Hypothermic Perfusion Enables 48-Hour Heart Preservation and Bench-Top Functional Recovery via Normothermic Reperfusion in a Porcine Model.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Review
- Molecular and cellular adaptations to extended hypothermic oxygenated perfusion in donation-after-circulatory-death hearts in a porcine model.Frontiers in cardiovascular medicine · 2026Article
- Ex vivo hypothermic oxygenated perfusion allows extended heart preservation in a donation-after-circulatory-death porcine model.medRxiv : the preprint server for health sciences · 2025Article
Corrections and comments
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Authors and funding
24 authors.
Funding
Abstract
backgroundEx vivo oxygenated perfusion systems are a promising approach to extend cardiac allograft preservation beyond the typical 4 to 6 hours limit allowed by static cold storage (SCS). Hypothermic oxygenated perfusion (HOPE) has been proven to safely preserve donor hearts, yet its underlying molecular mechanisms have not been extensively evaluated. The aim of the study is to characterize cardiomyocyte viability, transcriptomic and metabolomic responses, and functional recovery of porcine hearts preserved with HOPE for up to 48 hours, including evaluating their ability to regain sinus rhythm following bench-top normothermic reperfusion.
methodsSeventeen Yorkshire pigs underwent donor cardiectomy. In the first arm, 10 hearts were preserved for up to 48 hours using either SCS (n=5) or HOPE (n=5). Endomyocardial biopsies were collected at 0, 12, 24, and 48 hours for histology, RNA sequencing, flow cytometry, and metabolomics. In the second arm, 6 HOPE-preserved hearts (3, 24, 48 hours) and 2 SCS-preserved heart (3 and 24 hours) underwent 2 hours of normothermic reperfusion to simulate transplantation and assess reanimation.
resultsHOPE preserved cardiomyocyte viability and structural integrity for 48 hours, in contrast to SCS in both arms of the study. RNA sequencing and untargeted metabolomics revealed conserved energy-substrate profiles in HOPE and progressive ischemic metabolite accumulation in SCS. All HOPE hearts regained stable sinus rhythm.
conclusionsHOPE enables 48 hours ex vivo heart preservation while maintaining cardiomyocyte integrity, normal gross and microscopic architecture, and rapid functional recovery on bench-top reperfusion in a preclinical model. These findings establish a foundation for redefining clinical preservation times and widening geographic donor access.
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