Successful transplantation of high-risk cardiac allografts from DCD donors following ex vivo coronary angiography

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Disclosure statement

In relation to the work submitted, the authors declare no conflict of interest or external funding sources. Outside the submitted work, PM reports grants from Novartis and personal fees from Novartis, Astra-Zeneca, and Actelion.

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    It allows for continuous perfusion after DCD procurement, can measure metabolites to monitor coronary flow, and has the ability to increase flow if an increase in lactate or troponin is detected. Additionally, advanced diagnostic interventions, such as direct coronary angiography, have been performed successfully while using the Organ Care System before cardiac transplant.38 Further evaluation may be performed by measuring the physiologic and mechanical function of the heart by measuring preload-recruitable stroke work.

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    The first ex situ coronary angiogram of a beating heart on OCS was performed in 2014, revealing significant triple vessel disease [20]. More recently, two cases of successful ex situ coronary angiography on DCD hearts during EVHP have been reported [21]. Minor coronary artery disease was remarkable and allowed for organ transplantation.

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