Emergency donor heart protection: application of the port access catheter technique using a pig heart transplantation model

Transplantation
Albertus M ScheuleGerhard Ziemer

Abstract

Organ shortage limits the number of transplantations, and donor deterioration may precede and often prevent conventional organ preservation. This study evaluates in situ perfusion as a bedside method for cardiac allograft procurement in a large animal model. Thirty Landrace pigs (42 +/- 7 kg) were studied. The hearts in the conventional group underwent cardioplegic arrest with University of Wisconsin solution and sodium-hydrogen exchange inhibitor cariporide as an additive; they were explanted and stored on ice before transplantation. In the in situ group, one catheter was placed in the ascending aorta and another in the right atrium. After disconnection from the ventilator, hypoxia caused circulatory arrest. The aorta was endoclamped, and in situ perfusion of the aortic root was maintained with University of Wisconsin solution and cariporide. After explantation, hearts were stored on ice for 120 min. All hearts were implanted according to the Shumway technique. Ventricular pressure and cardiac output were monitored online, and troponin-I was measured intermittently. Two hours after weaning from extracorporal circulation, the animals were killed and histology was performed. Catheters were placed through introducers within 5 min...Continue Reading

References

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Citations

Aug 16, 2008·The New England Journal of Medicine·Mark M BoucekUNKNOWN Denver Children's Pediatric Heart Transplant Team
May 27, 2008·Morphologie : Bulletin De L'Association Des Anatomistes·T H M VieiraN Wafae
Sep 23, 2009·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Nabeel R ObeidJeffrey D Punch

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