Long-Term Conditioning of a Donor Heart by Autoperfusion

Abstract

The aim of research was to study parameters of homeostasis and conditions for stable operation of the autoperfused heart-lung complex ex vivo.Materials and methods. A series of acute experiments (n-3) was carried out to create a functioning heart-lung complex and study parameters of homeostasis ex vivo. A large mammal (mini-pig weighed 20-30 kg) was used as an experimental model. During the experiment, invasive blood pressure in the aortic root, pulmonary artery, central venous pressure, temperature of the left ventricle of the heart, gas composition of arterial blood (in the aortic root) and venous blood flowing from the coronary sinus was monitored.Results. The series of experiments evidenced the fundamental possibility of an isolated heart-lung complex ex vivo stable functioning. During 4-hours autoperfusion of the "heart-lung" complex, the parameters of hemodynamics, gas and biochemical blood composition remained within the reference values.Conclusion. The analysis of literature data and the results of experiments on laboratory animals allow us to state that the autoperfusion can be successfully used as an option of safe and long-term conditioning of a donor heart. This technique can be used to improve the results of heart transplantation with prolonged ischemia of the donor organ. Extending the survival of a donor heart ex vivo functioning will significantly expand the geography of donor bases, reducing the ischemic period to a minimum.