An innovative cold storage system for donor heart transportation- lessons learned from the first experience in Switzerland

Background: The current standard for donor heart preservation consists of cold organ storage in three sequential plastic bags. This technique can cause freezing injuries of the donor heart as the temperature inside the transport box is not monitored routinely. The SherpaPakTM Cardiac Transport System (CTS) (Paragonix Technologies, Cambridge, MA, USA) aims to resolve this problem by maintaining a controlled preservation temperature between 4 degrees C and 8 degrees C. This study reports the first single-centre experience in Switzerland with this innovative single-use disposable device. Methods: Between May and December 2020, four heart procurements using SherpaPakTM CTS were performed at our heart centre. Donor heart preservation fluid and ambient temperature were monitored using the InTempConnect (R) application (Onset Computer Corporation, Bourne, MA, USA). All patient data were collected retrospectively from the local hospital patient data capture system. Results: Four recipients of a donor heart preserved with SherpaPakTM CTS were included in this study (3 male, 1 female). Mean transport distance was 86 km (range, 45-276 km). Mean storage time in the cooler was 73.5 +/- 19.33 minutes. Mean cold ischemic time was 199.25 +/- 11.67 minutes. The device kept the average organ temperature between 5.2 degrees C and 8.8 degrees C and hereby reached the recommended temperature range of 5-10 degrees C. Modifications of the procurement and storage process provided an optimization of the temperature course in the transportation box. There were no incidents during the transport. Organs transported with this novel storage system showed normal function after transplantation. Conclusions: The SherpaPakTM CTS provides constant organ temperatures during transportation, prevents freezing injury and ensures mechanical protection of the graft.