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Posttransplant function of a nonbeating heart is predictable by an ex vivo perfusion method
K Suehiro1, M Mohri, H Yamaguchi
1Department of Cardiovascular Surgery, Okayama University Medical School, Japan.
The Annals of Thoracic Surgery
|February 24, 2001
Summary
Predicting posttransplant cardiac function in nonbeating donor hearts is possible. An ex vivo perfusion test accurately identifies hearts suitable for transplantation, improving donor heart selection.
Area of Science:
- Cardiology
- Transplantation Medicine
- Organ Preservation
Background:
- Assessing the viability of nonbeating donor hearts is crucial for successful heart transplantation.
- Current methods for evaluating donor heart function prior to transplantation have limitations.
Purpose of the Study:
- To determine if ex vivo assessment of nonbeating donor hearts can predict posttransplant cardiac function.
- To evaluate the efficacy of a specific ex vivo perfusion protocol in selecting viable donor hearts.
Main Methods:
- 13 canine hearts were subjected to 45 minutes of warm ischemia after cardiac arrest.
- Hearts were reperfused ex vivo and tested for ejection against an 80 mm Hg afterload.
- Following ex vivo assessment, hearts were transplanted orthotopically.
Main Results:
- Four of 13 hearts (31%) demonstrated successful ejection in the ex vivo apparatus.
- Hearts that ejected ex vivo (Group A) showed good posttransplant hemodynamics without inotropic support.
- Hearts that failed to eject ex vivo (Group B) required dopamine to support circulation post-transplant.
Conclusions:
- Ex vivo evaluation of nonbeating donor heart function accurately predicts posttransplant performance.
- This perfusion-based method offers a reliable approach for selecting transplantable hearts from nonbeating donors.
- Improved donor heart selection can enhance outcomes in heart transplantation.