The Effect of Warm Ischemic Intervals on Primary Graft Dysfunction in Normothermic Regional Perfusion for Donation After Circulatory Death Heart Transplant

This article investigated the role of different definitions of warm ischemia time during donation after circulatory death (DCD) heart transplants and the development of severe primary graft dysfunction (PGD). The authors found that prolonged donor hypoxia before normothermic regional perfusion (NRP)—specifically, more than 23 minutes in patients with a functional warm ischemic time defined by oxygen saturation below 80 percent—was associated with significantly higher rates of severe PGD. Interestingly, the authors also identified a linear association suggesting that elevated PGD rates correlated with increased ischemia time. Other outcomes, such as overall mortality and length of hospital stay, were not significantly different.