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Updated: Jun 28, 2025
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Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism
Published on: January 12, 2019
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Extending heart preservation to 24 h with normothermic perfusion
Brianna L Spencer1, Spencer K Wilhelm1, Christopher Stephan1
1Extracorporeal Life Support Laboratory, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, United States.
Frontiers in Cardiovascular Medicine
|April 19, 2024
Summary
This study demonstrates a novel normothermic ex situ heart perfusion (NEHP) technique successfully preserving porcine hearts for 24 hours. Interventions like hemofiltration and plasma exchange improved outcomes, showing NEHP
Area of Science:
- Cardiovascular Research
- Organ Preservation
- Biomedical Engineering
Background:
- Current heart preservation relies on cold static storage (CSS) for up to 6 hours, with longer durations increasing transplant risks.
- Existing normothermic ex situ heart perfusion (NEHP) systems are limited to 6 hours and lack objective cardiac function assessment.
Purpose of the Study:
- To develop and evaluate an NEHP system for extending heart preservation beyond 24 hours.
- To incorporate objective functional assessment into the NEHP system.
- To assess the feasibility of using blood-derived perfusate for prolonged heart perfusion.
Main Methods:
- Developed an NEHP system for aortic (Langendorff) perfusion using leukocyte/thrombocyte-depleted blood.
- Studied 42 porcine hearts divided into five groups, including control and intervention groups (plasma exchange, hemofiltration, intermittent left atrial perfusion).
- Evaluated heart viability and function during 24-hour NEHP.
Main Results:
- All hearts (n=27) with NEHP and interventions were successfully perfused for 24 hours.
- Control NEHP hearts (n=15) showed significantly higher failure rates (93.3% by 10-21 hours).
- Intermittent left atrial perfusion in larger hearts enabled real-time functional assessment and stability throughout 24-hour NEHP.
Conclusions:
- 24-hour heart preservation is feasible using the developed NEHP technique with interventions.
- NEHP offers potential to expand the donor pool by enabling objective functional assessment and longer preservation times.
- Further optimization is needed for extended preservation beyond 24 hours, infection control, and nutritional support.
