277 PRESSURE-TARGETED PERFUSION IS THE OPTIMAL STRATEGY OF THE PEDIATRIC EX-VIVO HEART PERFUSION FOR DONATION AFTER CARDIAC DEATH IN PORCINE MODEL J Kobayashi, S Luo, M Haranal, M Parker, J Wang, C Haller, O Honjo Toronto, Ontario BACKGROUND: Donation after cardiac death (DCD) offers a po- tential additional source of donor hearts. However, such donor hearts have more damages to the myocardium and the endothe- lium of coronary arteries which lead to serious reperfusion injury compared to standard donor hearts since DCD hearts experience warm ischemic time. Ex-vivo perfusion is an organ protection strategy that allows to minimize donor ischemic time and poten- tially treats the damaged hearts. However, no device is available for infants. The aim of this study is to investigate the optimal condi- tions of the ex-vivo perfusion strategy for infant DCD hearts. METHODS: Twelve juvenile pigs are divided into two groups according to the perfusion strategies: the flow-targeted group (group A, n¼6, target perfusion flow: 10ml/kg/min) and the pressure-targeted group (group B, n¼6, target perfusion pressure: 40mmHg). Mechanical ventilation was discontinued in the anesthetized pigs resulting in asphyxiation and circu- latory arrest. An additional 15 minutes of warm ischemic time (WIT) was observed. After cardioplegia was infused, the heart was retrieved. The hearts of both groups were perfused with the whole blood for two hours and switched to the working model where the heart ejects the blood without mechanical support and the cardiac function was assessed. RESULTS: Body weight, WIT, and cold ischemic time were not significantly different between two groups (table). Dur- ing the ex-vivo perfusion, the group A expressed significantly increased mean arterial pressure than that in the group B (group A: 69.7+/-13.6mmHg vs. group B: 40.1+/- 3.8mmHg, p<0.01) though there are no difference of perfusion flow between two groups. During the working model, the group B showed significantly increased cardiac output (A: 24.7+/-18.2ml/kg/min vs. B: 91.6+/-11.5ml/kg/ min, p<0.01) and mean arterial pressure (group A: 34.3+/- 8.0mmHg vs. group B: 48.5+/-7.3mmHg, p<0.05) compared with those in the group A though there are no significant difference of lactate level after ex-vivo perfusion between the two groups. Three animals (50%) in group A did not generate any measurable cardiac output. The heart edema after ex-vivo perfusion was smaller in the group B compared with that in the group A. CONCLUSION: These findings suggest that the pressure-tar- geted ex-vivo perfusion might be optimal as the ex-vivo perfusion strategy to reanimate the infant DCD hearts. 278 USE OF THE BIOMARKER NT-PROBNP TO TRIAGE PATIENTS INTO MULTIDISCIPLINARY HEART FUNCTION CLINIC: SINGLE CENTRE EXPERIENCE WITH CANADIAN APPLICABILITY C Tong, T Danylyshyn, S Kerr, E Swiggum Vancouver, British Columbia BACKGROUND: Heart failure (HF) management delivered by multidisciplinary heart function clinics (HFC) is associated with improved symptoms and less acute care utilization. Recognizing access to HFCs is limited in Canada, the Cana- dian Cardiovascular Society has published recommended benchmarks to promote timely referral and follow up fre- quency to specialized HFCs. However, there is no existing guidance in screening patients for entry into HFCs. Sup- ported by guidelines, patients with NT-proBNP level < 300 pg/mL are unlikely to have symptomatic HF. We investigated whether the addition of NT-proBNP level cutoff of 300 pg/ mL to standard clinical triage in our HFC since April 2014 would have any impact on health care utilization to patients not followed by the multidisciplinary clinic. METHODS: Retrospective cohort study of patients referred to the Royal Jubilee Hospital HFC (Victoria, BC) from April 2014 to March 2015 was conducted. Individuals with an NT-proBNP level < 300 pg/mL were triaged back to the referring physician for management in a non-multidisciplinary setting. Referrals Abstracts S177