AUTHOR=Mendiola Pla Michelle , Berrettoni Silvia , Lee Franklin H. , Rozzi Giacomo , Marrano Federica , Gross Ryan T. , Evans Amy , Wendell David C. , Lezberg Paul , Burattini Margherita , Paolo lo Muzio Francesco , Fassina Lorenzo , Milano Carmelo A. , Bang Marie-Louise , Bowles Dawn E. , Miragoli Michele 

TITLE=Video analysis of ex vivo beating hearts during preservation on the TransMedics® organ care system

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1216917

DOI=10.3389/fcvm.2023.1216917

ISSN=2297-055X

ABSTRACT=Background. Reliable biomarkers for assessing the viability of the donor hearts undergoing ex vivo perfusion remain elusive. A unique feature of normothermic ex vivo perfusion on the TransMedics Organ Care System (OCS) is that the donor heart is maintained in a beating state throughout the preservation period. We applied a video algorithm for in vivo assessment of cardiac kinematics (Vi.Ki.E.) to donor hearts undergoing perfusion on the OCS to assess feasibility of applying this algorithm in this setting. 
Methods. Healthy donor hearts (n=6) were procured from Yucatan pigs and underwent two hours of perfusion on the OCS device. During the preservation period, serial high-resolution videos were captured at 30 frames per second. Using Vi.Ki.E., we assessed the force, energy, contractility, and trajectory parameters of each heart. 
Results. There were no significant changes in any of the measured parameters of the heart on the OCS device over time. There were no significant changes in contractility during the duration of the preservation period (time 0-30 min, 918 ± 430 px/s; time 31-60 min, 1386 ± 603 px/s; time 61-90 min, 1299 ± 617 px/s; time 91-120 min, 1535 ± 728 px/s). Similarly, there were no significant changes in the force, energy, or trajectory parameters.
Conclusion. Vi.Ki.E. assessment of donor hearts undergoing ex vivo perfusion is feasible on the TransMedics OCS, and we observed that donor hearts maintain steady kinematic measurements throughout the duration. This technology can potentially be utilized to assess donor heart viability prior to transplantation.