Normothermic Ex Vivo Heart Perfusion: Effects of Live Animal Blood and Plasma Cross Circulation
| Autor: | Kristopher B. Deatrick, Fares Alghanem, Gabe E. Owens, Martin L. Bocks, Elena M. Perkins, Joseph T. Church, Robert H. Bartlett, John M. Trahanas, Joseph Phillips, Alvaro Rojas-Pena, Min Hee Song |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Swine medicine.medical_treatment Biomedical Engineering Biophysics Bioengineering 030204 cardiovascular system & hematology 030230 surgery Article Biomaterials Plasma 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Animals Whole blood Heart transplantation business.industry Organ Preservation General Medicine Cross Circulation Perfusion Transplantation Red blood cell medicine.anatomical_structure Vascular resistance Cardiology Heart Transplantation Vascular Resistance business Ex vivo |
| Zdroj: | ASAIO Journal. 63:766-773 |
| ISSN: | 1058-2916 |
| DOI: | 10.1097/mat.0000000000000583 |
| Popis: | Prolonged normothermic ex vivo heart perfusion could transform cardiac transplantation. To help identify perfusate components that might enable long-term perfusion, we evaluated the effects of cross-circulated whole blood and cross-circulated plasma from a live paracorporeal animal on donor porcine hearts preserved via normothermic ex vivo heart perfusion. Standard perfusion (SP; n = 40) utilized red blood cell/plasma perfusate and Langendorff technique for a goal of 12 hours. Cross-circulation groups used a similar circuit with the addition of cross-circulated venous whole blood (XC-blood; n = 6) or cross-circulated filtered plasma (XC-plasma; n = 7) between a live paracorporeal pig under anesthesia and the perfusate reservoir. Data included oxygen metabolism, vascular resistance, lactate production, left ventricular function, myocardial electrical impedance, and histopathologic injury score. All cross-circulation hearts were successfully perfused for 12 hours, compared with 22 of 40 SP hearts (55%; p = 0.002). Both cross-circulation groups demonstrated higher oxygen consumption and vascular resistance than standard hearts from hours 3-12. No significant differences were seen between XC-blood and XC-plasma hearts in any variable, including left ventricular dP/dT after 12 hours (1478 ± 700 mm Hg/s vs. 872 ± 500; p = 0.17). We conclude that cross circulation of whole blood or plasma from a live animal improves preservation of function of perfused hearts, and cross-circulated plasma performs similarly to cross-circulated whole blood. |
| Databáze: | OpenAIRE |
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