From the Extracorporeal Life Support Laboratory, Department of Surgery, Michigan Medicine, Ann Arbor, Michigan.
Department of Pathology, Michigan Medicine, Ann Arbor, Michigan.
ASAIO J. 2020 Jul;66(7):753-759. doi: 10.1097/MAT.0000000000001061.
Preservation of a donor heart for transplantation is limited to 6-8 hours. Based on our demonstration of 12 hour perfusion with plasma cross circulation, this study aimed to evaluate ex vivo heart perfusion (EVHP) for up to 72 hours using cross plasma circulation (XC-plasma) from a live, awake paracorporeal sheep (PCS). Six ovine hearts were perfused for 72 hours using plasma cross circulation at a rate of 1 L/min with a live, awake PCS. Controls were seven perfused hearts without cross circulation. Experiments were electively ended at 72 hours, and epinephrine (0.1 mg) was delivered to demonstrate hormonal responsiveness. All controls failed at 6-10 hours. All six hearts perfused for 72 hours maintained normal heart function, metabolism, and responsiveness to epinephrine. Blood gases, electrolytes, and lactate levels were normal and stable throughout the study. All hearts appeared suitable for transplantation. We have demonstrated successful normothermic EVHP for 72 hours.
供体心脏的保存时间限制在 6-8 小时内。基于我们对使用来自活体清醒体外羊(PCS)的血浆交叉循环进行 12 小时灌注的演示,本研究旨在使用来自活体清醒体外羊(PCS)的血浆交叉循环(XC-plasma)评估长达 72 小时的体外心脏灌注(EVHP)。使用来自活体清醒体外羊(PCS)的血浆交叉循环以 1L/min 的速度对 6 个绵羊心脏进行 72 小时的灌注。对照组为 7 个未进行交叉循环的灌注心脏。实验在 72 小时时选择性结束,并给予肾上腺素(0.1mg)以证明激素反应性。所有对照组在 6-10 小时内失败。所有 6 个灌注 72 小时的心脏均保持正常的心功能、代谢和对肾上腺素的反应性。血气、电解质和乳酸水平在整个研究期间均正常且稳定。所有心脏均适合移植。我们已经证明了 72 小时的成功常温 EVHP。