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A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Surgical techniques for cardiac procurement, preparation and perfusion using the Organ Care System
Manuel Egle1, Sarah Longnus2, Murat Yildiz3
1Department of Cardiac Surgery, Inselspital, Bern University Hospital, Bern, Switzerland Department for BioMedical Research, University of Bern, Switzerland Graduate School for Cellular and Biomedical Sciences, University of Bern, Switzerland.
Insights
This guide details preparing a donor heart for normothermic ex situ perfusion using the Organ Care System. This technique expands heart transplant eligibility and viability, aiding surgical teams in training and practice.
Area of Science:
- Cardiovascular Surgery
- Transplantation Medicine
- Medical Device Technology
Background:
- Normothermic ex situ cardiac perfusion is an emerging technique for heart transplantation.
- The TransMedics Organ Care System facilitates extended preservation and utilization of donor hearts.
- Current practices may limit donor heart availability and transplant success.
Purpose of the Study:
- To provide a step-by-step audio-visual guide for preparing a donor heart for normothermic ex situ perfusion.
- To support surgical teams in adopting and implementing this advanced perfusion technique.
- To enhance the utilization of donor hearts, including those from circulatory death and extended criteria donors.
Main Methods:
- Detailed audio-visual demonstration of donor heart preparation.
- Focus on steps for application with the TransMedics Organ Care System.
- Guidance for hearts donated after brain death.
Main Results:
- A comprehensive tutorial summarizing critical preparation steps.
- Facilitation of planning, training, and refresher for surgical teams.
- Potential to increase heart transplantation activity.
Conclusions:
- The video tutorial serves as a valuable resource for implementing normothermic ex situ cardiac perfusion.
- Wider adoption of this technique can overcome barriers in heart transplantation.
- This method enhances the viability and usability of donor organs.
Abstract:
We provide an audio-visual step-by-step guide to the preparation of a donor heart for the application of normothermic, ex situ cardiac perfusion on the TransMedics Organ Care System using a heart donated after brain death. The use of the Organ Care System increases heart transplantation activity by enabling the utilization of hearts donated after circulatory death, the use of extended criteria grafts and the extension of out-of-body time, which can help overcome geographic or surgical barriers. Ex situ cardiac perfusion is a new technique and is therefore not yet routinely performed in many centres. However, it can be assumed that this technique will become more established and widespread in the future. Our video tutorial, which summarizes all important steps, can therefore be of benefit to surgical teams for planning, training or as a refresher.
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