normothermic-ex-situ-heart-perfusion-working-mode-assessment-cardiac

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

The current standard method for organ preservation (cold storage, CS), exposes the heart to a period of cold ischemia that limits the safe preservation ...

normothermic-negative-pressure-ventilation-ex-situ-lung-perfusion

Normothermic Negative Pressure Ventilation <em>Ex Situ</em> Lung Perfusion: Evaluation of Lung Function and Metabolism

Lung transplantation (LTx) remains the standard of care for end-stage lung disease. A shortage of suitable donor organs and concerns over donor organ ...

left-lung-orthotopic-transplantation-juvenile-porcine-model-for

Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP

Lung transplantation is the gold-standard treatment for end-stage lung disease, with over 4,600 lung transplantations performed worldwide annually. ...

University of Alberta

Intralipid (ILE), a clinically used lipid emulsion, reduces ischemia-reperfusion (IR) injury in healthy and infarct-remodelled rat hearts. We tested whether ILE is also cardioprotective in large porcine hearts in the context of the donation after circulatory death (DCD) model, where human hearts are procured for transplantation after cardiac arrest and thus are exposed to significant IR injury.

Enhanced myocardial protection in cardiac donation after circulatory death using Intralipid postconditioning in a porcine model.

Myocardial function declines in a time-dependent fashion during ex situ heart perfusion. Cell death and metabolic alterations may contribute to this phenomenon, limiting the safe perfusion period and the potential of ex situ heart perfusion to expand the donor pool. Our aim was to investigate the etiology of myocardial functional decline in ex situ perfused hearts.

Myocardial Functional Decline During Prolonged Ex Situ Heart Perfusion.

Ex situ heart perfusion (ESHP) preserves the donated heart in a perfused, beating condition preventing cold storage-related ischemia and provides a platform to evaluate myocardial viability during preservation. However, myocardial function declines gradually during ESHP. Extracorporeal circulation systems are associated with the induction of systemic inflammatory and stress responses. Our aim was to evaluate the incidence of inflammation and induction of endoplasmic reticulum stress responses during an extended period of ESHP.

Immunity and Stress Responses Are Induced During Ex Situ Heart Perfusion.

Ex situ heart perfusion (ESHP) is being investigated as a method for the continuous preservation of the myocardium in a semiphysiologic state for subsequent transplantation. Most methods of ESHP position the isolated heart in a hanging (H) state, representing a considerable departure from the in vivo anatomical positioning of the heart and may negatively affect the functional preservation of the heart. In the current study, cardiac functional and metabolic parameters were assessed in healthy pig hearts, perfused for 12 hours, in either an H, or supported (S) position, either in nonworking mode (NWM) or working mode (WM). The cardiac function was best preserved in the S position hearts in WM (median 11 hour cardiac index (CI)/1 hour CI%: working mode perfusion in supported position = 94.77% versus nonworking mode perfusion in supported position = 62.80%, working mode perfusion in H position = 36.18%, nonworking mode perfusion in H position = 9.75%; p < 0.001). Delivery of pyruvate bolus significantly improved the function in S groups, however, only partially reversed myocardial dysfunction in the H heart groups. The hearts perfused ex situ in a semianatomical S position and in physiologic WM had better functional preservation and recovery than the H hearts in non-S position. Optimizing the positional support for the ex situ-perfused hearts may improve myocardial preservation during ESHP.

ArticleTotal : 3	Year
Publication title Cited by 22	2019
Publication title	2022
Publication title Cited by 1	2022

Article	Year
Enhanced myocardial protection in cardiac donation after circulatory death using Intralipid postconditioning in a porcine model. Canadian journal of anaesthesia = Journal canadien d'anesthesie\| PubMed ID: 30790198	2019
Myocardial Functional Decline During Prolonged Ex Situ Heart Perfusion. The Annals of thoracic surgery\| PubMed ID: 30872100	2019
Immunity and Stress Responses Are Induced During Ex Situ Heart Perfusion. Circulation. Heart failure\| PubMed ID: 32498623	2020
The Position of the Heart During Normothermic Ex Situ Heart Perfusion is an Important Factor in Preservation and Recovery of Myocardial Function. ASAIO journal (American Society for Artificial Internal Organs : 1992)\| PubMed ID: 33741785	2021

Xiao Qi

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