Abstract
In cardiac transplantation, the transport time between harvest and recipient is limited by the viability of the donor heart. The problem of viability is a consistent limitation in cardiac transplantation. Since the 1960s, techniques, including hypothermia, perfusion, oxygenation, and hyperbaria, have been used to prolong the preservation of the transplantable heart. Continuing development of cardioplegic solutions has minimized edema and oxygen radical formation, which have resulted in extension of the donor heart viability. New research into the events leading to necrosis, oncosis, and apoptosis may allow further advancement of protective cardioplegic solutions in combination with technology of transporting the heart. With a prolonged preservation time there is potential to increase the donor pool and ultimately improve post-operative outcomes.