OBJECTIVES: Surgical techniques and immunosuppressive drugs have been improved over the past decades, while the method of preserving and transporting organs has not. In the UK only 22.3% of hearts from all consented heart beating donors were recovered in June 2005, whilst cold ischeamic time (CIT) increased by an average of 34 minutes over 8 years. The Organ Care System (OCS) may alleviate the organ shortage and improve transplant outcomes by maintaining explanted hearts in the normal functioning state ex-vivo. A health economic evaluation analysis was undertaken to compute the economic benefit of improved transportability of explanted hearts from the UK societal point of view. METHODS: Improved preservation with OCS plus heart transplantation (IPTx) was compared to medical management on the transplantation waiting list (MM) and heart transplantation with conventional cold preservation method (CPTx). We assumed that IPTx increases heart transplantation rates by 40% and reduces CIT to <1hr. UK cost vectors were derived from the published literature. Twenty year direct medical costs and QALYs were calculated for each arm. Reducing CIT to <1hr may extend the graft half life by 2.2 years (Schnitzler 2006). Discount rates of 6% were used for costs and 1.5% for QALYs. WTP for a QALY gain was assumed to be 30,000 British Pounds (GBP). Cost of improved preservation technique was not included in the model. RESULTS: IPTx may generate 4.18 and 1.19 QALY gain vs MM and CPTx respectively by increasing heart transplantation rates and reducing the impact of CIT. Treatment costs are reduced by 4476 GBP vs MM and increased by 5768 GBP vs CPTx. CONCLUSION: Many patients die on the waiting list due to the lack of transportability of hearts from eligible donors. Improved preservation of explanted hearts may generate 58'496 GBP of economic value per each heart transplantation.