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A novel compartmentalised stent graft to isolate the perfusion of the abdominal organs
Yanfei Chen1, Bryan W Tillman2,3,4, Sung Kwon Cho5
1a Department of Industrial Engineering , University of Pittsburgh , Pittsburgh , PA , USA.
Insights
A novel stent graft design isolates abdominal organ perfusion during donation after cardiac death, mitigating injury from low blood flow. This approach improves organ recovery without increasing cardiac stress, addressing donor organ shortages.
Area of Science:
- Biomedical Engineering
- Transplant Surgery
- Medical Devices
Background:
- Donation after cardiac death (DCD) is crucial for addressing organ shortages.
- Low blood flow in DCD donors causes organ injury, hindering recovery.
- Existing methods lack effective solutions for preserving organ perfusion during DCD.
Purpose of the Study:
- To propose and evaluate a novel compartmentalised stent graft.
- To isolate abdominal organ perfusion from systemic malperfusion in DCD donors.
- To improve organ blood flow and reduce injury without increasing cardiac stress.
Main Methods:
- Computational fluid dynamics (CFD) analysis of stent conditions.
- In vitro validation using two stent prototypes.
- Fluoroscopic device placement studies in a swine model.
Main Results:
- CFD analysis confirmed feasibility of isolated perfusion.
- Hydrodynamic pressure drop across the stent was negligible (0.14–0.22 mmHg).
- Swine model studies demonstrated successful device placement.
Conclusions:
- The compartmentalised stent graft design is feasible for rapid isolation of abdominal organ perfusion.
- This novel approach shows potential for improving organ recovery in DCD.
- The device respects ethical considerations by not increasing cardiac stress.
Abstract:
Donation after cardiac death has been adopted to address the critical shortage of donor organs for transplant. Recovery of these organs is hindered by low blood flow that leads to permanent organ injury. We propose a novel approach to isolate the perfusion of the abdominal organs from the systemic malperfusion of the dying donor. We reasoned that this design could improve blood flow to organs without open surgery, while respecting the ethical principle that cardiac stress not be increased during organ recovery. Conditions within the stent were analysed using a computational fluid dynamics (CFD) method and validated on two prototypes in vitro. The hydrodynamic pressure drop across the stent was measured as 0.14-0.22 mmHg, which is a negligible influence. Device placement studies were also conducted on swine model fluoroscopically. All these results demonstrated the feasibility of rapidly isolating the perfusion to abdominal organs using a compartmentalised stent graft design.
