The field of heart transplantation is critical for patients with end-stage heart failure, yet it is constrained by the limited availability of suitable donor hearts. The expansion of the donor pool through the use of extended criteria donor organs is a pressing need, prompting the transplant community to explore innovative preservation technologies and strategies. Recent advancements, such as the Paragonix SherpaPak Cardiac Transport System and ex vivo perfusion methods like the Organ Care System (OCS), have shown promise in improving recipient outcomes and expanding the usability of donor hearts with extended ischemic times. However, despite these technological strides, the challenge of ischemic injury to the graft during cold storage remains a significant risk factor for post-transplant morbidity and mortality. Studies have also investigated the impact of different preservation solutions and mechanical circulatory support (MCS) devices on post-transplant outcomes, revealing variability in the incidence of complications such as primary graft dysfunction (PGD). This evolving landscape underscores the need for ongoing research to optimize heart preservation and transport methods, with the ultimate goal of improving patient outcomes and expanding the donor heart pool.

This research topic aims to synthesize current knowledge and foster new investigations into the optimization of donor heart preservation and transport. It seeks to understand the comparative effectiveness of various preservation solutions and technologies, such as static cold storage (SCS), hypothermic machine perfusion, and normothermic perfusion, in reducing ischemic injury and improving post-transplant outcomes. Additionally, research to explore the potential of novel pharmacological and cardioprotective interventions during preservation, the implications of donor-recipient size matching, and the impact of pre-transplant patient management on post-transplant complications is necessary.

To gather further insights in the field of donor heart preservation and transport, we welcome articles addressing, but not limited to, the following themes:

- Comparative studies on the efficacy of different heart preservation solutions and technologies (e.g., University of Wisconsin solution, HTK, Celsior solution).

- The role of mechanical circulatory support devices in bridging to heart transplantation and their impact on post-transplant outcomes.

- Investigations into the use of novel cardioprotective agents and interventions during machine perfusion.

- Analysis of the effects of donor-recipient size matching metrics on post-transplant clinical outcomes.

- Evaluation of the impact of pre-transplant patient management strategies, such as amiodarone exposure, on the incidence of primary graft dysfunction and other post-transplant complications.

- Studies on the utilization of extended criteria donor hearts and the outcomes associated with different transport systems, including static hypothermic preservation and normothermic perfusion.

- Research into the molecular and genetic markers of graft health, such as donor-derived cell-free DNA, and their correlation with clinical outcomes.

- Reviews of current practices and future directions in heart transplantation, including the use of marginal grafts and allocation algorithms.

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Frontiers in Transplantation

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