Ex Vivo Heart Perfusion for 72 Hours Using Plasma Cross Circulation

Area of Science:

• Cardiovascular Surgery
• Organ Preservation
• Transplantation Medicine

Background:

• Current donor heart preservation is limited to 6-8 hours, restricting transplantation viability.
• Previous research demonstrated 12-hour perfusion using plasma cross-circulation.

Purpose of the Study:

• To evaluate the efficacy of ex vivo heart perfusion (EVHP) for extended preservation up to 72 hours.
• To assess the feasibility of using cross-plasma circulation from a live, awake paracorporeal sheep (PCS) for EVHP.

Main Methods:

• Six ovine hearts underwent 72-hour EVHP with cross-plasma circulation (XC-plasma) at 1 L/min from a live, awake PCS.
• Control group consisted of seven hearts perfused without cross-circulation.
• Hormonal responsiveness was tested with epinephrine (0.1 mg) at study completion.

Main Results:

• All control hearts failed within 6-10 hours.
• All six hearts in the XC-plasma group maintained normal function, metabolism, and hormonal responsiveness for 72 hours.
• Stable blood gases, electrolytes, and lactate levels were observed throughout the 72-hour perfusion period.

Conclusions:

• Normothermic EVHP using XC-plasma is successful for up to 72 hours.
• This extended preservation method shows potential for improving donor heart viability for transplantation.
• The technique maintained excellent heart function and metabolic stability over an extended period.