CARDIOVASCULAR ANESTHESIA: Edited by Nirvik PalMitochondrial transplantation in cardiac surgical patients: optimism, caveats, and outstanding questionsCherry, Anne D. Author Information Department of Anesthesiology, Duke University, Durham, North Carolina, USA Correspondence to Anne D. Cherry, Department of Anesthesiology, Duke University, DUMC Box 3094, Durham, NC 27710, USA. Tel: +1 919 681 3551; e-mail: [email protected] Current Opinion in Anaesthesiology 36(1):p 5-10, February 2023. | DOI: 10.1097/ACO.0000000000001202 Buy Metrics Abstract Purpose of review Mitochondria satisfy the high metabolic demand of the heart, and also play major roles in reactive oxygen species signaling, calcium buffering, and regulation of cell death. Mitochondrial damage or dysfunction can drive diseases seen in cardiac surgical patients, including heart failure and ischemia/reperfusion injury. Exogenous transplantation of isolated mitochondria has been proposed as one way to augment mitochondrial function and mitigate a number of pathologic processes, with a heavy focus on ischemia/reperfusion injury. Recent findings Animal models of cardiac ischemia/reperfusion injury have shown functional benefits after mitochondrial transplantation. Many of the mechanisms underlying this therapy's effect; optimal dosing, delivery, and timing; and how it will translate to cardiac surgical patients are yet unknown. Summary Mitochondrial transplantation is a potential therapeutic strategy for cardiac ischemia/reperfusion injury. Effective application to selected cardiac surgical patients can be informed by further mechanistic investigations. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.