Low-Flow Hypothermic Crystalloid Perfusion Is Superior to Cold Storage During Prolonged Heart Preservation

Ou, Ruchong; Lim, Yi Wee; Choong, Jiun; Esmore, Donald; Salamonsen, Robert F.; McLean, Catriona; Forbes, Josephine M.; Bailey, Michael; Rosenfeldt, Franklin

doi:10.1016/j.transproceed.2014.09.149

Cited by 15 publications

(10 citation statements)

References 22 publications

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“…One report of successful prolonged hypothermic ex vivo heart perfusion from the Steen group showed successful heart function in animals, verified by transplantation, after 24-hour ex vivo perfusion. 6 In our literature review of NEVP, we found only 50 reports of successful perfusion for ≥24 hours, all using a perfusion circuit similar to an infant ECMO circuit. 7 There are currently three companies manufacturing devices for clinical human normothermic organ perfusion: Transmedics Organ Care System (heart, lung, liver), Organox (liver), and XVIVO perfusion system (lung).…”

Section: Discussionmentioning

confidence: 99%

Prolonged (24-hour) Normothermic ex vivo Heart Perfusion Facilitated by Perfusate Hemofiltration

Johnson¹,

Fallon²,

Langley³

et al. 2022

ASAIO Journal

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Currently, normothermic ex vivo heart perfusion (NEVHP) is limited to 6-12 hours. NEVHP for 24 hours or more would allow organ treatment, assessment of organ function, and nearperfect recipient matching. We present a model of NEVHP using continuous hemofiltration (HFn) with sustained myocardial viability up to 24 hours. Twenty hearts from 6-10 kg piglets were procured and maintained on our NEVHP circuit. HFn hearts (n = 10) underwent NEVHP with HFn, whereas controls (n = 10) used NEVHP alone. All HFn vs. four controls were viable at 24 h (p = 0.004). At end perfusion, HFn hearts had higher left ventricular systolic pressure (51.5 ± 6.8 mm Hg, 38.3 ± 5.2 mm Hg, p = 0.05), lower coronary resistance (0.83 ± 0.11 mm Hg/mL/min, 1.18 ± 0.21mmHg/mL/min, p < 0.05), and lower serum lactate levels (2.9 ± 0.4 mmol/L, 4.1 ± 0.6 mmol/L, p < 0.0001) when compared to control hearts. HFn hearts also had less extensive myocardial damage and significantly less edema than control hearts with lower weight gain and wet-dry ratios. Using our circuit, NEVHP for 24 hours is possible with HFn and allows for preservation of myocardial function, improved tissue viability, decreased tissue edema, and less myocardial injury.

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Section: Discussionmentioning

confidence: 99%

Prolonged (24-hour) Normothermic ex vivo Heart Perfusion Facilitated by Perfusate Hemofiltration

Johnson¹,

Fallon²,

Langley³

et al. 2022

ASAIO Journal

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“…They also showed that low-flow hypothermic perfusion with supplemented St. Thomas' solution, which is a high potassium-, magnesium-, and procainebased cardioplegia, could preserve hearts for up to 20 h in a small animal mode. These hearts demonstrated good recovery of function on a Langendorff working preparation (Ou et al 2014).…”

Section: Animal Experimentation Hypothermic Machine Perfusionmentioning

confidence: 90%

Ex Vivo Perfusion

Smith¹,

Fiedler²

2020

Organ and Tissue Transplantation

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“…For this reason, perfusate with high osmolality or high concentration of oncotic agents has demonstrated better results in edema prevention. 17,18…”

Section: Hypothermic Ex Vivo Nonbeating Machine Perfusion (Hmp)mentioning

confidence: 99%

Nonischemic Donor Heart Preservation: New Milestone in Heart Transplantation History

et al. 2023

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Heart transplantation is considered the gold standard for the treatment of advanced end-stage heart failure. However, standard donors after brain death are decreasing, whereas patients on the heart transplant waitlist are constantly rising. The introduction of the ex vivo machine perfusion device has been a turning point; in fact, these systems are able to significantly reduce ischemic times and have a potential effect on ischemia-related damage reduction. From a clinical standpoint, these machines show emerging results in terms of heart donor pool expansion, making marginal donors and donor grafts after circulatory death suitable for donation. This article aims to review mechanisms and preclinical and clinical outcomes of currently available ex vivo perfusion systems, and to explore the future fields of application of these technologies.

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Low-Flow Hypothermic Crystalloid Perfusion Is Superior to Cold Storage During Prolonged Heart Preservation

Cited by 15 publications

References 22 publications

Prolonged (24-hour) Normothermic ex vivo Heart Perfusion Facilitated by Perfusate Hemofiltration

Prolonged (24-hour) Normothermic ex vivo Heart Perfusion Facilitated by Perfusate Hemofiltration

Ex Vivo Perfusion

Nonischemic Donor Heart Preservation: New Milestone in Heart Transplantation History

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