2 Heart Preservation: Conventional Versus Novel Techniques Adam Pampori and Robert S. Poston Corresponding Author: Robert S. Poston Jack G. Copeland Endowed Chair of Cardiovascular Surgery Michael Drummond Distinguished Professor of Cardiovascular and Thoracic Surgery Chief, Division of Cardiac and Thoracic Surgery Co-Chairman, Sarver Heart Center University of Arizona School of Medicine 1501 N. Campbell Avenue Tucson, AZ 85724-5071e-mail: rposton@surgery.arizona.edu 21 Abstract The heart is one of the most difficult organs to preserve given the requirement to return to full function immediately after transplant. Thus, the current pres- ervation time for the heart is 3–6 hours. Continuous perfusion has an advan- tage over cold storage in that aerobic metabolism and removal of waste are possible. Continuous perfusion has the potential for pharmacologic or gene therapeutic intervention. Finally, continuous perfusion allows meaningful ex vivo evaluation of the condition of the organ prior to transplant. Key terms continuous perfusion, machine perfusion, heart preservation, aerobic metabolism, nonheart-beating donor, myocardial preservation, heart transplantation