Heart failure & cardiomyopathies

Endothelial and inflammatory responses during ex vivo normothermic perfusion of human cardiac grafts

ESC Heart FailPublished 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
5 consecutive donor hearts
Exposure
Perfusate biomarkers over time during normothermic ex vivo heart perfusion (NEVHP), expressed as fold-change vs T0
Outcome
Feasibility of sequential sampling

Main finding

As reported in the abstract

  • 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

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

Composed by AI from the published abstract and checked against it. How Briefs are made →

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