Portable perfusion device could increase ischemic time of donor hearts significantly,...

Researchers have developed a portable perfusion device capable of maintaining excised pig hearts in a beating state for 12 hours without significant ischemia-reperfusion injury. If the device works equally well in humans, it could prolong the preservation of donor hearts, improve transplant

Shukri Khuri, MD from the West Roxbury VA Medical Center in Massachusetts and colleagues maintained 6 swine hearts on the device for 12 hours, replacing the blood after 6 hours of preservation. Next, they stopped the hearts, then reperfused them with fresh blood 30 minutes later, maintaining the organs in a beating state for another 2 hours. For comparison, the investigators stopped and excised 5 other pig hearts, immersed them in University of Wisconsin solution, and stored the organs on ice for 12 hours. They then used the portable device to reperfuse the hearts for 2 hours.

"Maintenance of the donor heart in the beating, working state for 12 hours resulted in complete preservation of contractile, metabolic, and vasomotor function," the research team reports in the November issue of the Journal of Thoracic Cardiovascular Surgery.

During the reperfusion period, the team detected significantly less myocardial tissue acidosis, deterioration of left ventricular pressure, edema, and endothelial dysfunction in the hearts that had been kept beating compared to the ice-stored organs. Moreover, all stored hearts, but no perfused hearts, required direct current shock in order to return to sinus rhythm upon perfusion.

"Prolonged safe preservation not only will allow for better histocompatibility cross-matching, thus reducing the risk of early graft rejection, but also will create the flexibility to perform the transplant procedure as an elective case," Dr. Khuri and colleagues predict. Other benefits, the authors say, might include a reduced incidence of allograft vasculopathy and an increased pool of available donors because of the possibility of remote organ procurement.