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

Sanaz Hatami; Christopher W. White; Martin Ondrus; Xiao Qi; Max Buchko; Sayed Himmat; Lily Lin; Katie Cameron; David Nobes; Hyun-Joong Chung; Jayan Nagendran; Darren H. Freed

doi:10.3791/58430

Normotérmica Ex Situ coração perfusão na modalidade de trabalho: avaliação da função cardíaca e m...

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

Normotérmica Ex Situ coração perfusão na modalidade de trabalho: avaliação da função cardíaca e metabolismo

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09:10 min

January 12, 2019

DOI: 10.3791/58430-v

Sanaz Hatami¹, Christopher W. White¹, Martin Ondrus¹, Xiao Qi¹, Max Buchko¹, Sayed Himmat¹, Lily Lin², Katie Cameron³, David Nobes⁴, Hyun-Joong Chung⁵, Jayan Nagendran^1,6, Darren H. Freed^1,3,6,7

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

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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.

Frequently Asked Questions

What is normothermic ex situ heart perfusion?

It is a technique that preserves the heart in a beating, semi-physiologic state for evaluation.

Why is visual demonstration important in this method?

Visual aids help overcome the technical challenges of connecting the heart safely.

How does ESHP improve donor heart evaluation?

It allows for direct functional assessments rather than relying solely on metabolic indicators.

What are the main advantages of using ESHP?

It enables repeated assessments of heart function and provides insights into organ viability.

What challenges do beginners face with this technique?

Beginners may struggle with the technical aspects of heart retrieval and connection.

What is the significance of assessing heart response to stimuli?

It helps confirm the viability and functionality of the donor heart before transplantation.

Normotérmica ex situ coração perfusão (ESHP), preserva o coração em um estado semi fisiológico, batendo. Quando executada em um modo de funcionamento, ESHP fornece a oportunidade de realizar avaliações sofisticadas de doador viabilidade de função e de órgão do coração. Aqui, descrevemos nosso método para a avaliação de desempenho do miocárdio durante ESHP.

Este método pode ajudar a responder a perguntas-chave sobre a preservação ideal dos corações dos doadores, bem como sua avaliação funcional e metabólica para a adequação subsequente do transplante. A principal vantagem dessa técnica é que permite uma avaliação funcional do coração doador que não se baseia apenas em avaliações metabólicas indiretas. As implicações dessa técnica se estendem para a terapia de corações doadores disfuncionais, pois a função cardíaca pode ser avaliada de forma fácil e repetida ao longo do tempo.

Geralmente, indivíduos novos neste assunto lutarão porque alguns conhecimentos técnicos são necessários para conectar o coração de forma segura e segura. A demonstração visual deste método é fundamental, pois os aspectos técnicos da recuperação do coração e da conexão com o dispositivo podem ser desafiadores para aprender apenas por instrução de texto. Depois de confirmar a falta de resposta a estímulos nocivos, realize uma esternotomia mediana no porco anestesiado e uma vez que o coração tenha sido exposto, use uma tesoura Metzenbaum para abrir o pericárdio.

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