Normothermic Ex Vivo Heart Perfusion: Effects of Live Animal Blood and Plasma Cross Circulation. Issue 6 (November 2017)

• Record Type: Journal Article
• Authors: Church, Joseph T.; Alghanem, Fares; Deatrick, Kristopher B.; Trahanas, John M.; Phillips, Joseph P.; Hee Song, Min; Perkins, Elena M.; Bartlett, Robert H.; Rojas-Pena, Alvaro; Bocks, Martin L.; Owens, Gabe E.
• Is Part Of: ASAIO journal. Volume 63:Issue 6(2017)
• Publication Date: 2017-11
• Subjects: EVHP -- heart perfusion -- ex vivo -- cross circulation -- paracorporeal; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000000583
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : 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.