Autoperfusing ectothermic heart-lung preservation system

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
J Y Kresh, S K Brockman

Abstract

A portable heart-lung preservation system was developed to enable distant organ procurement. In 8 dogs, a functioning heart-lung system was isolated, cannulated in situ, removed en bloc, and placed into a Plasmalyte-filled, temperature-controlled (15-38 degrees C) chamber. The perfusion circuit consisted of an adjustable-height, autologous-blood reservoir. The heart ejected through the aortic cannula with venous return (VR) into the superior vena cava. Respiration was maintained with a positive pressure ventilator. Intramyocardial tissue pressure (IMP), tissue pH, right atrial (RAP), aortic pressure (AOP), and cardiac output (CO) were monitored. Autoperfusion at normothermia and CO of 50 mL/min/kg resulted in early (3 h) deterioration of pulmonary function with progressive interstitial lung edema. Pulmonary dysfunction always preceded changes in regional myocardial contractile viability (peak IMP and d(IMP)/dt) and global function (CO, AOP). When tissue pH was regulated ectothermically (as in cold-blooded animals) (delta pH/degrees C = -0.015) the heart maintained a stable pumping mode (greater than 6 h) at myocardial temperatures of 17-28 degrees C, pH = 7.70-7.55, and heart rate of 25-50 bpm, respectively. The results indicat...Continue Reading

References

Mar 11, 1982·The New England Journal of Medicine·B A ReitzN E Shumway

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Citations

Jan 1, 1991·Journal of Pharmaceutical and Biomedical Analysis·S M CarterR W Logan
Feb 1, 1992·The Annals of Thoracic Surgery·C M GencoJ T Diehl

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