The heart that took the scenic route: Europe’s record-breaking 9-hours OCS journey

We report Europe’s longest documented heart perfusion using the Transmedics Organ Care System (OCS) during a heart transplantation. A 55-year-old patient with end-stage heart failure received a donor heart after 536 min (8 h 55 min) of OCS perfusion and a total out-of-body time of 676 min (11 h 16 min). Due to adverse weather, air transport was not possible, necessitating an extended ground-based journey. Despite initial vasospasm, perfusion parameters remained stable. The heart demonstrated immediate post-transplant function without need of mechanical support. This case demonstrates the potential of the OCS to extend preservation times beyond conventional limits, increasing access to viable donor organs and optimizing transplantation outcomes.