(541) A Probable Winner in the Race for the Best Cardiac Preservation Solution: A Single-Center's Experience

PurposeManufacturing disruptions in the University of Wisconsin (UW) cardiac preservation solution during the COVID-19 pandemic forced medical centers (MC) to rely upon alternative preservation solutions in the USA. Demands of excellence during this disruptive period prompted an analysis comparing the most commonly used solutions and their adverse postoperative outcomes in heart transplant recipients.MethodsThe United Network for Organ Sharing (UNOS) database was retrospectively reviewed from 1/30/2003 to 6/5/2022 for adult heart transplant recipients. Primary stratification was by solution type with evaluation of only UW and CS preservation solutions. Secondary stratification was for the center with the best 1-year outcomes per SRTR reports. Primary endpoints were survival and length of stay. Secondary endpoints were acute graft rejection, intubation status, and use of ECMO, IABP, and inotropes.ResultsAfter exclusion criteria, a total of 584 adult heart transplant recipients were identified prior to the start of the national UW shortage. 558 hearts used UW (96%) and 26 hearts used CS (4%). Analysis of Cox regression models for survival revealed greater survival at 2000, 4000, and 6000 days post transplant for UW as compared to CS (p = 0.019, Fig. 1). Analysis of Fischer's exact test revealed UW showed less use of ECMO (p = <0.001), IABP (p = 0.041), and lower intubation status (p = <0.001) at 72 hours post-transplant (Fig. 1). There was no significant difference in length of stay and inotrope use.ConclusionEvaluation of the two most commonly used heart preservation solutions nationwide reveals that UW has improved patient outcomes with regard to survival, use of ECMO and IABP, and intubation status at 72 hours post-transplant. Manufacturing disruptions in the University of Wisconsin (UW) cardiac preservation solution during the COVID-19 pandemic forced medical centers (MC) to rely upon alternative preservation solutions in the USA. Demands of excellence during this disruptive period prompted an analysis comparing the most commonly used solutions and their adverse postoperative outcomes in heart transplant recipients. The United Network for Organ Sharing (UNOS) database was retrospectively reviewed from 1/30/2003 to 6/5/2022 for adult heart transplant recipients. Primary stratification was by solution type with evaluation of only UW and CS preservation solutions. Secondary stratification was for the center with the best 1-year outcomes per SRTR reports. Primary endpoints were survival and length of stay. Secondary endpoints were acute graft rejection, intubation status, and use of ECMO, IABP, and inotropes. After exclusion criteria, a total of 584 adult heart transplant recipients were identified prior to the start of the national UW shortage. 558 hearts used UW (96%) and 26 hearts used CS (4%). Analysis of Cox regression models for survival revealed greater survival at 2000, 4000, and 6000 days post transplant for UW as compared to CS (p = 0.019, Fig. 1). Analysis of Fischer's exact test revealed UW showed less use of ECMO (p = <0.001), IABP (p = 0.041), and lower intubation status (p = <0.001) at 72 hours post-transplant (Fig. 1). There was no significant difference in length of stay and inotrope use. Evaluation of the two most commonly used heart preservation solutions nationwide reveals that UW has improved patient outcomes with regard to survival, use of ECMO and IABP, and intubation status at 72 hours post-transplant.