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Updated: Jun 19, 2025
Closed Chest Biventricular Pressure-Volume Loop Recordings with Admittance Catheters in a Porcine Model
Published on: May 18, 2021
Ex Situ Left Ventricular Pressure-Volume Loop Analyses for Donor Hearts: Proof of Concept in an Ovine Experimental
I A Ertugrul1, R A D A Puspitarani2, B Wijntjes3
1Department of Cardiothoracic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands.
Insights
A new pressure-volume loop system accurately assesses left ventricular function during ex situ heart perfusion (ESHP). This method offers improved graft selection for donation after brain death (DBD) and donation after circulatory death (DCD) donor hearts.
Area of Science:
- Cardiology
- Transplantation Medicine
- Physiology
Background:
- Ex situ heart perfusion (ESHP) is crucial for preserving donor hearts from both brain death (DBD) and circulatory death (DCD) donors.
- Current viability assessment relies on biochemical markers, lacking a reliable method for evaluating graft function in a working state.
- Functional assessment during ESHP is critical for predicting post-transplantation outcomes.
Purpose of the Study:
- To evaluate a novel pressure-volume loop analysis system for assessing left ventricular function during normothermic ESHP.
- To introduce a method for real-time functional graft assessment in a physiologic working mode.
Main Methods:
- Ovine hearts underwent functional evaluation using a novel pressure-volume loop system during normothermic ESHP.
- The system provided adjustable preload and afterload to the left ventricle.
- Left ventricular function was assessed by measuring end-systolic elastance at varying preloads.
Main Results:
- The novel pressure-volume loop system successfully assessed ovine left ventricular function during ESHP.
- End-systolic elastance values were recorded at 60 minutes (2.8 ± 1.8 mmHg/mL) and 120 minutes (2.7 ± 0.7 mmHg/mL).
Conclusions:
- A novel method using ex situ pressure-volume loop analysis for functional graft assessment during ESHP has been demonstrated.
- This validated pressure-volume assessment technique could enhance graft selection for both DBD and DCD donor hearts.
Abstract:
Ex situ heart perfusion (ESHP) has emerged as an important strategy to preserve donation after brain death (DBD) and donation after circulatory death (DCD) donor hearts. Clinically, both DBD and DCD hearts are successfully preserved using ESHP. Viability assessment is currently based on biochemical values, while a reliable method for graft function assessment in a physiologic working mode is unavailable. As functional assessment during ESHP has demonstrated the highest predictive value of outcome post-transplantation, this is an important area for improvement. In this study, a novel method for ex situ assessment of left ventricular function with pressure-volume loop analyses is evaluated. Ovine hearts were functionally evaluated during normothermic ESHP with the novel pressure-volume loop system. This system provides an afterload and adjustable preload to the left ventricle. By increasing the preload and measuring end-systolic elastance, the system could successfully assess the left ventricular function. End-systolic elastance at 60 min and 120 min was 2.8 ± 1.8 mmHg/mL and 2.7 ± 0.7 mmHg/mL, respectively. In this study we show a novel method for functional graft assessment with ex situ pressure-loop analyses during ESHP. When further validated, this method for pressure-volume assessments, could be used for better graft selection in both DBD and DCD donor hearts.
