Amesz Jorik H, Lupgens Niki L, Duncker Dirk J, Sluijter-Rozendaal Lisa E, Dumay Dwight, Manintveld Olivier C, Taverne Yannick J H J
From the Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
Experimental Cardiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
ASAIO J. 2025 Jun 1;71(6):e90-e93. doi: 10.1097/MAT.0000000000002394. Epub 2025 Feb 20.
Myocardial edema significantly develops during current subnormothermic ex situ heart perfusion (ESHP) procedures, resulting in myocardial function decline during prolonged perfusion. A relatively high coronary blood flow (CBF) during ESHP is thought to be responsible for this high degree of myocardial edema formation. In this study, we present a novel tool to calculate CBF based on individual donor (sex and body weight) and perfusate (hemoglobin concentration, oxygen saturation, partial pressure of oxygen [PO 2 ]) characteristics. The tool continuously evaluates the balance between myocardial oxygen consumption (MVO 2 ) and delivery to facilitate adequate and preventing excess perfusion. Taking this personalized approach, the CBF can potentially be lowered while still providing sufficient oxygen to the donor heart. Furthermore, the tool automatically calculates MVO 2 , ΔPO 2 , and coronary vascular resistance during ESHP, which aids in the qualitative assessment of the heart before transplantation.
在当前的亚低温体外心脏灌注（ESHP）过程中，心肌水肿会显著发展，导致长时间灌注期间心肌功能下降。ESHP期间相对较高的冠状动脉血流量（CBF）被认为是这种高度心肌水肿形成的原因。在本研究中，我们提出了一种基于个体供体（性别和体重）和灌注液（血红蛋白浓度、氧饱和度、氧分压[PO₂]）特征来计算CBF的新工具。该工具持续评估心肌氧消耗（MVO₂）与输送之间的平衡，以促进充分灌注并防止过度灌注。采用这种个性化方法，在仍为供体心脏提供足够氧气的同时，CBF有可能降低。此外，该工具在ESHP期间自动计算MVO₂、ΔPO₂和冠状动脉血管阻力，这有助于在移植前对心脏进行定性评估。
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