Ex vivo perfusion of the donor heart: Preliminary experience in high-risk transplantations

Van, Simon Dang; Gaillard, Maïra; Laverdure, Florent; Thès, Jacques; Venhard, Jean Christophe; Mohamed, Fahim; Vallée, Aurélien; Ramadan, Ramzi; Hébert, Guillaume; Tamarat, Radia; Deleuze, Philippe; Guihaire, Julien

doi:10.1016/j.acvd.2021.07.003

Cited by 12 publications

(10 citation statements)

References 27 publications

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“…Laboratory methods that are used include measuring lactate and lactate differential between arterial and venous blood, as well as potassium and calcium levels ( Figure 2 B). Donors with unknown coronary artery disease can undergo ex vivo angiography with C-arm fluoroscopy [ 9 ]. In addition, at the recipient site, the surgeon can evaluate the clinical function of the allograft prior to implantation.…”

Section: Ex-vivo Normothermic Perfusion—transmedics Organ Care Systemmentioning

confidence: 99%

“…At present, the literature supports the use of OCS. By 2021, there will have been approximately 1100 transplanted hearts using the OCS, of which 800 were from DBD donors and 300 were from DCD donors [ 9 ]. The PROTECT II trial was a prospective multi-institutional study that compared standard-criteria hearts implanted with cold storage vs. OCS.…”

Section: Literature Review Of the Ocs Device And Its Outcomesmentioning

confidence: 99%

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Ex-Vivo Preservation of Heart Allografts—An Overview of the Current State

Kothari

2023

JCDD

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As heart transplantation continues to be the gold-standard therapy for end-stage heart failure, the supply-demand imbalance of available organs worsens. Until recently, there have been no advances in increasing the donor pool, as prolonged cold ischemic time excludes the use of certain donors. The TransMedics Organ Care System (OCS) allows for ex-vivo normothermic perfusion, which allows for a reduction of cold ischemic time and allows for long-distance procurements. Furthermore, the OCS allows for real-time monitoring and assessment of allograft quality, which can be crucial for extended-criteria donors or donation after cardiac death (DCD) donors. Conversely, the XVIVO device allows for hypothermic perfusion to preserve allografts. Despite their limitations, these devices have the potential to alleviate the supply-demand imbalance in donor availability.

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Section: Ex-vivo Normothermic Perfusion—transmedics Organ Care Systemmentioning

confidence: 99%

Section: Literature Review Of the Ocs Device And Its Outcomesmentioning

confidence: 99%

Ex-Vivo Preservation of Heart Allografts—An Overview of the Current State

Kothari

2023

JCDD

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“…Dang Van et al. recently reported their preliminary experience of ex situ perfusion of the donor heart in high risk transplantation 4 . In this clinical series, surgeons performed a coronary angiography during ESHP.…”

Section: Introductionmentioning

confidence: 97%

“…Ex situ heart perfusion (ESHP) is an innovative approach to improve the preservation of the donor heart before transplantation. 4 , 5 This method allows for continuous organ monitoring including metabolic assessment of myocardial viability. ICA is the gold standard method for CAD diagnosis because of its high contrast and spatially resolved imaging capabilities but has been poorly reported during ESHP because of potential iatrogenic concerns including myocardial edema due to accumulation of contrast agent, coronary dissection, and infection.…”

Section: Introductionmentioning

confidence: 99%

“…However, ICA is only performed in one-third of donors at risk for CAD, mainly due to logistic reasons. Ex situ heart perfusion (ESHP) is an innovative approach to improve the preservation of the donor heart before transplantation 4 , 5 . This method allows for continuous organ monitoring including metabolic assessment of myocardial viability.…”

Section: Introductionmentioning

confidence: 99%

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Imaging the vasculature of a beating heart by dynamic speckle: the challenge of a quasiperiodic motion

et al. 2023

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. The spatial and temporal evolution of the field backscattered by a beating heart while illuminated with a coherent light reveals its macro- and microvascularization in real time. To perform these vascularization images, we use a recently published method of laser speckle imaging, based on the selective detection of spatially depolarized speckle field that is mainly generated by multiple scattering. We consider the calculation of the speckle contrast, by a spatial or temporal estimation. We show that the signal-to-noise ratio of the observed vascular structure can be noticeably increased by a postprocessing method implying the calculation of a motion field that allows the selection of similar frames extracted from different heartbeat periods. This later optimization reveals vascular microstructures with a spatial resolution of the order of .

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