TY - JOUR
T1 - Ex Situ Left Ventricular Pressure-Volume Loop Analyses for Donor Hearts
T2 - Proof of Concept in an Ovine Experimental Model
AU - Ertugrul, I. A.
AU - Puspitarani, R. A.D.A.
AU - Wijntjes, B.
AU - Vervoorn, M. T.
AU - Ballan, E. M.
AU - van der Kaaij, N. P.
AU - van Goor, H.
AU - Westenbrink, B. D.
AU - van der Plaats, A.
AU - Nijhuis, F.
AU - van Suylen, V.
AU - Erasmus, M. E.
N1 - Publisher Copyright:
Copyright © 2024 Ertugrul, Puspitarani, Wijntjes, Vervoorn, Ballan, van der Kaaij, van Goor, Westenbrink, van der Plaats, Nijhuis, van Suylen and Erasmus.
PY - 2024/7/11
Y1 - 2024/7/11
N2 - Ex situ heart perfusion (ESHP) has emerged as an important strategy to preserve donation after brain death (DBD) and donation after circulatory death (DCD) donor hearts. Clinically, both DBD and DCD hearts are successfully preserved using ESHP. Viability assessment is currently based on biochemical values, while a reliable method for graft function assessment in a physiologic working mode is unavailable. As functional assessment during ESHP has demonstrated the highest predictive value of outcome post-transplantation, this is an important area for improvement. In this study, a novel method for ex situ assessment of left ventricular function with pressure-volume loop analyses is evaluated. Ovine hearts were functionally evaluated during normothermic ESHP with the novel pressure-volume loop system. This system provides an afterload and adjustable preload to the left ventricle. By increasing the preload and measuring end-systolic elastance, the system could successfully assess the left ventricular function. End-systolic elastance at 60 min and 120 min was 2.8 ± 1.8 mmHg/mL and 2.7 ± 0.7 mmHg/mL, respectively. In this study we show a novel method for functional graft assessment with ex situ pressure-loop analyses during ESHP. When further validated, this method for pressure-volume assessments, could be used for better graft selection in both DBD and DCD donor hearts.
AB - Ex situ heart perfusion (ESHP) has emerged as an important strategy to preserve donation after brain death (DBD) and donation after circulatory death (DCD) donor hearts. Clinically, both DBD and DCD hearts are successfully preserved using ESHP. Viability assessment is currently based on biochemical values, while a reliable method for graft function assessment in a physiologic working mode is unavailable. As functional assessment during ESHP has demonstrated the highest predictive value of outcome post-transplantation, this is an important area for improvement. In this study, a novel method for ex situ assessment of left ventricular function with pressure-volume loop analyses is evaluated. Ovine hearts were functionally evaluated during normothermic ESHP with the novel pressure-volume loop system. This system provides an afterload and adjustable preload to the left ventricle. By increasing the preload and measuring end-systolic elastance, the system could successfully assess the left ventricular function. End-systolic elastance at 60 min and 120 min was 2.8 ± 1.8 mmHg/mL and 2.7 ± 0.7 mmHg/mL, respectively. In this study we show a novel method for functional graft assessment with ex situ pressure-loop analyses during ESHP. When further validated, this method for pressure-volume assessments, could be used for better graft selection in both DBD and DCD donor hearts.
KW - donation after circulatory death (DCD)
KW - ex situ heart perfusion
KW - functional evaluation
KW - heart transplantation
KW - viability assessment
UR - http://www.scopus.com/inward/record.url?scp=85199334292&partnerID=8YFLogxK
U2 - 10.3389/ti.2024.12982
DO - 10.3389/ti.2024.12982
M3 - Article
C2 - 39055346
AN - SCOPUS:85199334292
SN - 0934-0874
VL - 37
JO - Transplant International
JF - Transplant International
M1 - 12982
ER -