Use of SherpaPak™ CTS for Organ Transportation during Heart Transplantation: First Clinical Use in United Kingdom and Outcomes

Purpose SherpaPak™ CTS is CE marked and FDA approved device for organ transportation during heart transplantation. This device maintains organ temperature between 4-8°C which is the recommended temperature range by ISHLT 2020 consensus statement to prevent potential freezing damage. The aim of study was to analyse the outcomes and learning points from its first clinical use in United Kingdom, in our unit. Methods We prospectively collected the data on 7 consecutive patients where SherpaPak™ was used for transportation of heart from December 2019 to September 2020. We analysed the donor and recipient demographics, transport parameters and clinical outcomes of these patients. Results Patients median age was 50 years (range 19 - 61 years). Primary diagnosis was idiopathic dilated cardiomyopathy (n=4), ischaemic cardiomyopathy (n=2) and familial dilated cardiomyopathy (n=1). Median Total ischemic time was 150 minutes (IQR 120 - 213 minutes). Median transport time on SherpaPak™ was 71 minutes (IQR 53 - 129 minutes), with a median organ temperature of 5.54°C (IQR 4.66°C - 6.28°C) while median outside environment temperature was 18.58°C (IQR 17.89°C - 21.10°C). Intra-operatively, all hearts transported on SherpaPak™ were found to be soft and supple, with no frost damage. Among the 7 heart transplant patients, 4 patients were VAD explants. 1 patient required VA ECMO on day 1 for RV failure due to high pulmonary vascular resistance, while 6 did not need any mechanical support postoperatively. 5 patients have been successfully discharged from the hospital while the last 2 who had transplant done during last 2 weeks, are still inpatient and recovering in the ITU. Median ICU stay was 16 days (IQR 5-16 days) and median hospital stay was 27 days (IQR 25-34 days). Conclusion Our results demonstrate that SherpaPak™ is a safe device for organ transportation during heart transplantation. Further experience is needed to understand potential benefits and costs effectiveness