Transplantation from a donor in asystole requires that the heart, once retrieved, be restarted inside an ex vivo perfusion machine (a device that allows the organ’s transport time to be extended) and preserved at a temperature of 37 °C. For implantation, the heart must be stopped again. These stop-and-go phases cause what is known as ischemia–reperfusion injury.

Professor Woo at Stanford had already performed, for the first time in the world, a transplant—meaning the implantation of the heart—without stopping it after removal from the ex vivo perfusion machine.

In Padua, this technique was further improved, as a fully beating-heart transplant from a donor in asystole was performed. The heart is restarted inside the donor, retrieved without being stopped, and placed into the ex vivo perfusion machine, where it continues beating at 37 °C. This made it possible to completely eliminate the stop-and-go phases responsible for ischemia–reperfusion injury.