Heart failure & cardiomyopathiesCohort study
Endothelial and inflammatory responses during ex vivo normothermic perfusion of human cardiac grafts
- single-centre, prospective, observational pilot study
Authors' conclusion
Sequential biomarker monitoring during NEVHP was feasible and demonstrated inflammatory, endothelial, and haemostatic changes. These biological patterns require confirmation in larger cohorts, as potential tools for graft assessment and optimization of perfusion circuits and perfusate composition.
Study context
- Population
- Consecutive donor hearts preserved with the TransMedics Organ Care System (OCS) at the University Hospital of Rennes between March 2021 and January 2023
- Participants
- five consecutive donor hearts
- Exposure
- Perfusate biomarkers over time during normothermic ex vivo heart perfusion (NEVHP), expressed as fold-change vs T0
Main finding
As reported in the abstract
Feasibility of sequential sampling
- Sequential sampling was successful in all perfusions
Observational data: associations, not effects.
Further findings
Inflammatory mediators · T3 vs T0
- IL-8 fold-change
- 11.5-fold (95% CI 6.5-20.1)
- bFGF fold-change
- 8.4-fold (6.7-10.5)
- IL-6 fold-change
- 4.5-fold (2.4-8.2)
- MCP-1/CCL2 fold-change
- 4.1-fold (2.6-6.6)
- IL-10 and TNF-α fold-change
- 2.0- and 1.6-fold
Leukocyte counts
- Leukocyte count at T0
- 0.57 × 109/L
- Leukocyte fold-change
- 0.9
- remained stable
Endothelial markers
- Angiopoietin-2 fold-change
- 1.6-fold (1.2-2.1)
- VEGF fold-change
- 2.0-fold (1.2-3.5)
- Angiopoietin-1, syndecan-1, soluble E-selectin, thrombomodulin, VEGFR2, PlGF, and vWF:Ag showed minimal or inconsistent changes
- activation without evidence of injury
Haemostatic markers
- Heparin level (median)
- 6.9 IU/ml
- D-dimer fold-change
- 1.9-fold (1.3-2.7)
- Fibrin monomer fold-change
- 2.2-fold (1.2-3.9)
- Soluble P-selectin fold-change
- 1.5-fold (1.1-2.0)
- Platelet counts relative to baseline
- 0.8 (0.7-0.9)
Haematocrit
- Haematocrit
- 15.5% to 14.6%
- Haematocrit fold-change
- 0.94
- consistent with mild haemodilution
Donor and recipient characteristics and transplantation
- Donor median age
- 44 years (IQR 36-50)
- Donor male
- 60%
- Recipient mean age
- 53 ± 9 years
- Recipient female
- 20%
- All grafts were transplanted
Safety
Severe primary graft dysfunction
- Developed severe primary graft dysfunction
- Two of five (40%)
Original publication
Endothelial and inflammatory responses during ex vivo normothermic perfusion of human cardiac grafts. ESC Heart Fail. Published 18 April 2026. doi:10.1093/eschf/xvag114
Summarised from the published abstract; every number is checked against it