Initial Experience With Del Nido Cardioplegia in Adult Cardiac Transplantation

Del Nido Cardioplegia (DNC) is widely used in nontransplant cardiac surgery, but its role as a preservation solution in cardiac transplantation is unclear. We conducted a retrospective observational study of 61 patients undergoing heart transplant between January 2015 and December 2023. Only recipients with locally procured donor hearts were included. Recipients were grouped according to the type of preservative solution: DNC (n = 33) versus control (crystalloid + cold blood cardioplegia; n = 28). Patients in the DNC group were older and more frequently received hearts from donation after circulatory death. The Del Nido Cardioplegia group had lower troponin-T release at 48 hours (median [interquartile range {IQR}]: 1,062 [820] vs. 700 [345]; p = 0.03). Compared with the DNC, control group was related with longer ischemic (median [IQR]: 65 [55-83] vs. 80 [70.2-92.7] minutes; p = 0.002) and bypass times (median [IQR]: 90 [73.5-112] vs. 108 [97-118] minutes; p = 0.001). On-pump blood glucose levels and need for electrical defibrillation were lower with DNC. In heart transplantation using locally procured grafts, DNC appears to be a feasible preservation strategy. Del Nido Cardioplegia was associated with shorter operative times and lower troponin release in our initial experience. Further studies should be performed to confirm these promising results.