Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism

作者： Sanaz Hatami1, Christopher W. White1, Martin Ondrus1, Xiao Qi1, Max Buchko1, Sayed Himmat1, Lily Lin2, Katie Cameron3, David Nobes4, Hyun-Joong Chung5, Jayan Nagendran1,6, Darren H. Freed1,3,6,7 1Department of Surgery, Faculty of Medicine,University of Alberta, 2Department of Pediatrics, Faculty of Medicine,University of Alberta, 3Department of Biomedical Engineering, Faculty of Medicine,University of Alberta, 4Department of Mechanical Engineering, Faculty of Engineering,University of Alberta, 5Department of Chemical and Materials Engineering, Faculty of Engineering,University of Alberta, 6Canadian National Transplant Research Program, 7Department of Physiology, Faculty of Medicine,University of Alberta

简介：

Overview

Normothermic ex situ heart perfusion (ESHP) maintains the heart in a semi-physiologic state, allowing for detailed assessments of donor heart function. This method enables the evaluation of donor hearts beyond indirect metabolic assessments, providing insights into their viability for transplantation.

Key Study Components

Area of Science

• Cardiovascular physiology
• Transplantation science
• Organ preservation techniques

Background

• ESHP allows for the functional evaluation of donor hearts.
• It addresses key questions regarding heart preservation and suitability for transplantation.
• Technical expertise is required for the safe connection of the heart to the perfusion device.
• Visual demonstrations are essential for learning the technical aspects of the procedure.

Purpose of Study

• To evaluate donor heart function during ESHP.
• To assess the viability of donor hearts for transplantation.
• To improve techniques for preserving and evaluating donor hearts.

Methods Used

• Median sternotomy performed on anesthetized pigs.
• Use of Metzenbaum scissors to open the pericardium.
• Assessment of heart response to noxious stimuli.
• Connection of the heart to an ex situ perfusion device.

Main Results

• Functional evaluations can be performed repeatedly over time.
• The method allows for direct assessment of heart function.
• Technical challenges can be mitigated through visual instruction.
• Improved understanding of donor heart viability for transplantation.

Conclusions

• ESHP provides a reliable method for evaluating donor hearts.
• The technique enhances the potential for successful heart transplantation.
• Future studies may expand on the implications of this method for dysfunctional donor hearts.

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