Oxygenated machine perfusion at room temperature as an alternative for static cold storage in porcine donor hearts

Vincent van Suylen*, Katrien Vandendriessche, Arne Neyrinck, Foppe Nijhuis, Arjan van der Plaats, Erik K. Verbeken, Pieter Vermeersch, Bart Meyns, Massimo A. Mariani, Filip Rega, Michiel E. Erasmus

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
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Abstract

Background There is a continued interest in ex situ heart perfusion as an alternative strategy for donor heart preservation. We hypothesize that oxygenated machine perfusion of donor hearts at a temperature that avoids both normothermia and deep hypothermia offers adequate and safe preservation. Methods Cardioplegia-arrested porcine donor hearts were randomly assigned to six hours of preservation using cold storage (CS, n = 5) or machine perfusion using an oxygenated acellular perfusate at 21 degrees C (MP, n = 5). Subsequently, all grafts were evaluated using the Langendorff method for 120 min. Metabolic parameters and histology were analyzed. Systolic function was assessed by contractility and elastance. Diastolic function was assessed by lusitropy and stiffness. Results For both groups, in vivo baseline and post-Langendorff biopsies were comparable, as were lactate difference and myocardial oxygen consumption. Injury markers gradually increased and were comparable. Significant weight gain was seen in MP (p = 0.008). Diastolic function was not impaired in MP, and lusitropy was superior from 30 min up to 90 min of reperfusion. Contractility was superior in MP during the first hour of evaluation. Conclusion We conclude that the initial functional outcome of MP-preserved hearts was transiently superior compared to CS, with no histological injury post-Langendorff. Our machine perfusion strategy could offer feasible and safe storage of hearts prior to transplantation. Future studies are warranted for further optimization.

Original languageEnglish
Pages (from-to)246-258
Number of pages13
JournalARTIFICIAL ORGANS
Volume46
Issue number2
Early online date11-Oct-2021
DOIs
Publication statusPublished - 2022

Keywords

  • evaluation
  • ex situ heart perfusion
  • machine perfusion
  • preservation
  • temperature
  • EX-VIVO
  • INTERNATIONAL SOCIETY
  • CIRCULATORY DEATH
  • BRAIN-DEATH
  • PRESERVATION
  • TRANSPLANTATION
  • RECOVERY
  • FLOW
  • CARDIOPLEGIA
  • HYPOTHERMIA

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