Related Experiment Video
Updated: May 20, 2025
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
A Cardioprotective perfusion protocol limits myocardial functional decline during ex situ heart perfusion
Mats T Vervoorn1, Elisa M Ballan1,2,3, Sjoerd van Tuijl4
1University Medical Center Utrecht, Department of Cardiothoracic Surgery, Division of Heart & Lungs, Utrecht, the Netherlands.
Background:
Ex situ heart perfusion is associated with a significant decline in graft quality related to oxidative stress, inflammation, endothelial dysfunction, and metabolic perturbations. We assessed the effects of a more optimized, cardioprotective normothermic perfusion approach compared to a conventional perfusion protocol in a slaughterhouse model using porcine hearts.
Methods:
A total of 12 hearts were harvested and subjected to 4 hours of normothermic perfusion. The optimized protocol consisted of an adenosine-lidocaine cardioplegic solution, subnormothermic initial reperfusion and controlled rewarming, hemofiltration and supplementation of methylprednisolone and pyruvate. This was compared to a conventional protocol consisting of St. Thomas II cardioplegic solution, normothermic initial reperfusion without hemofiltration or methylprednisolone, and a mixture of glucose and insulin for metabolic support.
Results:
Myocardial function was superior in the optimized group, while significant functional decline was absent. Hearts subjected to the conventional protocol demonstrated a significant reduction in function over time.
Conclusions:
We have developed a further optimized, cardioprotective normothermic ex situ heart perfusion approach and demonstrated significantly improved myocardial function and attenuated functional decline during 4 hours of normothermic perfusion, indicating improved preservation.
