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Machine perfusion heart

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https://www.readbyqxmd.com/read/29025029/ct-coronary-imaging-a-fast-evolving-world
#1
Prabhakar Rajiah, Suhny Abbara
Computed tomography (CT) has become an important modality in the evaluation of coronary artery disease (CAD). The tremendous technological advances in CT in the last two decades has made it possible to obtain high quality images of coronary arteries with high spatial and temporal resolutions. Multiple trials have confirmed the accuracy of CT compared to invasive catheter angiography. CT is also able to evaluate beyond the lumen in characterizing and quantifying atherosclerotic plaques, including evaluation of high risk features...
September 4, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28800676/development-and-evaluation-of-heartbeat-a-machine-perfusion-heart-preservation-system
#2
Yongnan Li, Qingdong Zeng, Gang Liu, Junzhe Du, Bingren Gao, Wei Wang, Zhe Zheng, Shengshou Hu, Bingyang Ji
Static cold storage is accompanied with a partial safe ischemic interval for donor hearts. In this current study, a machine perfusion system was built to provide a better preservation for the donor heart and assessment for myocardial function. Chinese mini-swine (weight 30-35 kg, n = 16) were randomly divided into HTK, Celsior, and Heartbeat groups. All donor hearts were respectively preserved for 8 hours under static cold storage or machine perfusion. The perfusion solution is aimed to maintain its homeostasis based on monitoring the Heartbeat group...
August 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28746080/determination-of-optimal-coronary-flow-for-the-preservation-of-donation-after-circulatory-death-in-murine-heart-model
#3
Mohammed Quader, Stefano Toldo, Juan Torrado, Suraj Mishra, Adolfo G Mauro, Eleonora Mezzaroma, Reichstetter Heather, Antonio Abbate, Vigneshwar Kasirajan, Martin Mangino
Donation after circulatory death donors (DCD) have the potential to increase the number of heart transplants. The DCD hearts undergo an extended period of warm ischemia, which mandates the use of machine perfusion preservation if they are to be successfully recovered for transplantation. Because the minimum coronary artery flow needed to meet the basal oxygen demand (DCRIT) of a DCD heart during machine perfusion preservation is critical and yet unknown, we studied this in a DCD rat heart model. Adult male rats were anesthetized, intubated, heparinized, and paralyzed with vecuronium...
July 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28705994/wearable-brain-imaging-with-multi-modal-physiological-recording
#4
Gary E Strangman, Vladimir Ivkovic, Quan Zhang
The brain is a central component of cognitive and physical human performance. Measures including functional brain activation, cerebral perfusion, cerebral oxygenation, evoked electrical responses, and resting hemodynamic and electrical activity are all related to, or can predict health status or performance decrements. However, measuring brain physiology typically requires large, stationary machines that are not suitable for mobile or self-monitoring. Moreover, when individuals are ambulatory, systemic physiological fluctuations-e...
July 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28641140/effect-of-c1-inh-on-ischemia-reperfusion-injury-in-a-porcine-limb-ex-vivo-perfusion-model
#5
Mai M Abdelhafez, Jane Shaw, Damian Sutter, Jonas Schnider, Yara Banz, Hansjörg Jenni, Esther Voegelin, Mihai A Constantinescu, Robert Rieben
Revascularization of an amputated limb within 4-6h is essential to avoid extensive ischemia/reperfusion (I/R) injury leading to vascular leakage, edema and tissue necrosis. I/R injury is a pathological inflammatory condition that occurs during reperfusion of an organ or tissue after prolonged ischemia. It is characterized by a complex crosstalk between endothelial cell activation and the activation of plasma cascades. Vasculoprotective pharmacological intervention to prevent I/R injury might be an option to prolong the time window between limb amputation and successful replantation...
August 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28456774/lung-protection-in-cardio-pulmonary-bypass
#6
A Salameh, W Greimann, M Vollroth, S Dhein, M Bahramsoltani, I Dahnert
Since the invention of the heart-lung machine paediatric cardiac surgery developed rapidly. For correction of complex cardiac malformations the application of a cardio-pulmonary bypass (CPB) has become indispensable but possible negative effects of this technique should not be neglected. Especially, both bypassed organs i.e. heart and lung are not perfused during the procedure and therefore are threatened by ischemia and reperfusion injury. Additionally, CPB was developed with a non-pulsatile flow but there are clinical observations that pulsatile flow might be superior with improved patient outcomes...
February 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28418441/an-integrated-anti-arrhythmic-target-network-of-a-chinese-medicine-compound-wenxin-keli-revealed-by-combined-machine-learning-and-molecular-pathway-analysis
#7
Taiyi Wang, Ming Lu, Qunqun Du, Xi Yao, Peng Zhang, Xiaonan Chen, Weiwei Xie, Zheng Li, Yuling Ma, Yan Zhu
Wenxin Keli (WK), a Chinese patent medicine, is known to be effective against cardiac arrhythmias and heart failure. Although a number of electrophysiological findings regarding its therapeutic effect have been reported, the active components and system-level characterizations of the component-target interactions of WK have yet to be elucidated. In the current study, we present the first report of a new protective effect of WK on suppressing anti-arrhythmic-agent-induced arrhythmias. In a model of isolated guinea pig hearts, rapid perfusion of quinidine altered the heart rate and prolonged the Q-T interval...
May 2, 2017: Molecular BioSystems
https://www.readbyqxmd.com/read/28403128/an-oxygenated-and-transportable-machine-perfusion-system-fully-rescues-liver-grafts-exposed-to-lethal-ischemic-damage-in-a-pig-model-of-dcd-liver-transplantation
#8
Philippe Compagnon, Eric Levesque, Hassen Hentati, Mara Disabato, Julien Calderaro, Cyrille Feray, Anne Corlu, José Laurent Cohen, Ismail Ben Mosbah, Daniel Azoulay
BACKGROUND: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. METHODS: Cardiac arrest was induced in female large white pigs by intravenous injection of potassium chloride...
July 2017: Transplantation
https://www.readbyqxmd.com/read/28240643/heart-allograft-preservation-an-arduous-journey-from-the-donor-to-the-recipient
#9
Michiel Erasmus, Arne Neyrink, Mario Sabatino, Luciano Potena
PURPOSE OF REVIEW: The discrepancy between needs and availability of organs for heart transplantation may be partially reduced by improving the utilization of organs currently deemed unsuitable. Strategies to achieve this goal need optimization of the entire process of organ procurement, transportation, and functional recovery after transplant. RECENT FINDINGS: In the latest years, several studies reported improvements in organ utilization after appropriate donor management, and management of heart transportation is approaching a new era...
February 24, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28237004/nuclear-medicine-in-pediatric-cardiology
#10
REVIEW
Ornella Milanesi, Giovanni Stellin, Pietro Zucchetta
Accurate cardiovascular imaging is essential for the successful management of patients with congenital heart disease (CHD). Echocardiography and angiography have been for long time the most important imaging modalities in pediatric cardiology, but nuclear medicine has contributed in many situations to the comprehension of physiological consequences of CHD, quantifying pulmonary blood flow symmetry or right-to-left shunting. In recent times, remarkable improvements in imaging equipments, particularly in multidetector computed tomography and magnetic resonance imaging, have led to the progressive integration of high resolution modalities in the clinical workup of children affected by CHD, reducing the role of diagnostic angiography...
March 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/27729705/selective-heart-brain-and-body-perfusion-in-open-aortic-arch-replacement
#11
Sven Maier, Fabian Kari, Bartosz Rylski, Matthias Siepe, Christoph Benk, Friedhelm Beyersdorf
Open aortic arch replacement is a complex and challenging procedure, especially in post dissection aneurysms and in redo procedures after previous surgery of the ascending aorta or aortic root. We report our experience with the simultaneous selective perfusion of heart, brain, and remaining body to ensure optimal perfusion and to minimize perfusion-related risks during these procedures. We used a specially configured heart-lung machine with a centrifugal pump as arterial pump and an additional roller pump for the selective cerebral perfusion...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27664875/ex-vivo-oxygenated-perfusion-of-free-flaps-during-ischemia-time-a-feasibility-study-in-a-porcine-model-and-preliminary-results
#12
Nicholas J Slater, Her J H Zegers, Benno Küsters, Thimpe Beune, Henri A van Swieten, Dietmar J O Ulrich
BACKGROUND: Under ideal circumstances, creation of the anastomosis during free flap transfer is a routine task and can be performed under short ischemia time. However, vessels may be in suboptimal state due to atherosclerosis, radiotherapy or trauma, increasing difficulties regarding receptor vessel identification, and anastomosis which in turn may lead to lengthening of ischemia time resulting in postoperative wound problems or even flap loss. In the current pilot study, a modified heart-lung machine was assembled to achieve continuous oxygenated extracoporeal perfusion using porcine myocutaneous rectus abdominis flaps, aimed at minimizing tissue damage occurring during ischemia time...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27489600/comparison-of-current-practices-of-cardiopulmonary-perfusion-technology-in-iran-with-american-society-of-extracorporeal-technology-s-standards
#13
Amir Faravan, Nooredin Mohammadi, Alireza Alizadeh Ghavidel, Mohammad Zia Toutounchi, Ameneh Ghanbari, Mehran Mazloomi
INTRODUCTION: Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology...
2016: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/27327879/protection-of-the-transplant-kidney-from-preservation-injury-by-inhibition-of-matrix-metalloproteinases
#14
Michael A J Moser, Steve Arcand, Han-Bin Lin, Chris Wojnarowicz, Jolanta Sawicka, Tamalina Banerjee, Yigang Luo, Gavin R Beck, Patrick P Luke, Grzegorz Sawicki
BACKGROUND: Matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, play an important role in ischemic injury to the heart, yet it is not known if these MMPs are involved in the injury that occurs to the transplant kidney. We therefore studied the pharmacologic protection of transplant kidneys during machine cold perfusion. METHODS: Human kidney perfusates were analyzed for the presence of injury markers such as cytochrome c oxidase, lactate dehydrogenase, and neutrophil-gelatinase associated lipocalin (NGAL), and MMP-2 and MMP-9 were measured...
2016: PloS One
https://www.readbyqxmd.com/read/27160493/successful-transplantation-in-canines-after-long-term-coronary-sinus-machine-perfusion-preservation-of-donor-hearts
#15
Sarah Brant, Cyonna Holmes, Michael Cobert, LaShondra Powell, John Shelton, Michael Jessen, Matthias Peltz
BACKGROUND: Machine perfusion is a promising strategy for donor heart preservation, but delivery of perfusate through the aorta may be limited by aortic valve incompetence. We hypothesized that retrograde machine perfusion preservation through the coronary sinus avoided this issue and allowed for recovery of donor hearts after long-term storage. METHODS: Canine hearts were procured after arrest with 1 liter University of Wisconsin Machine Perfusion Solution (UWMPS) and preserved for 14 hours by static hypothermic storage (Static group, n = 5) or retrograde machine perfusion through the coronary sinus (RP group, n = 5)...
August 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/26967996/extracorporeal-heart-perfusion-before-heart-transplantation-the-heart-in-a-box
#16
Peter S Macdonald, Hong C Chew, Mark Connellan, Kumud Dhital
PURPOSE OF REVIEW: Cold static storage is a time-tested and simple method of preserving hearts retrieved from optimal donors after brain death (DBD). The increasing gap between supply and demand for donor organs together with changing donor and recipient characteristics have led to renewed interest in the use of machine perfusion to increase both the quality and quantity of donor hearts for transplantation. RECENT FINDINGS: Two major approaches to machine perfusion of donor hearts have been investigated - hypothermic (HMP) and normothermic machine perfusion (NMP)...
June 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/26825636/atls-hypovolemic-shock-classification-by-prediction-of-blood-loss-in-rats-using-regression-models
#17
Soo Beom Choi, Joon Yul Choi, Jee Soo Park, Deok Won Kim
In our previous study, our input data set consisted of 78 rats, the blood loss in percent as a dependent variable, and 11 independent variables (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, respiration rate, temperature, perfusion index, lactate concentration, shock index, and new index (lactate concentration/perfusion)). The machine learning methods for multicategory classification were applied to a rat model in acute hemorrhage to predict the four Advanced Trauma Life Support (ATLS) hypovolemic shock classes for triage in our previous study...
July 2016: Shock
https://www.readbyqxmd.com/read/26730095/post-mortem-reperfusion-of-a-pig-a-first-step-to-a-new-surgical-training-model
#18
Wouter Willaert, Filip De Somer, Silke Grabherr, Katharina D'Herde, Piet Pattyn
The purpose of this experimental study was to establish a short-term post-mortem circulation in a pig model using liquid paraffin. This study also investigated the quality of vascular perfusion in the peripheral tissues. This is the first step in the development of a new revascularized human surgical training model. This first experience was performed on the hind leg of a pig. Initial cannulation of the external iliac artery and vein was followed by connection of the arterial inflow to a heart-lung machine and using the venous outflow to flush post-mortem clots and blood...
December 2015: Indian Journal of Surgery
https://www.readbyqxmd.com/read/26650574/comparative-study-on-the-migration-of-di-2-ethylhexyl-phthalate-dehp-and-tri-2-ethylhexyl-trimellitate-totm-into-blood-from-pvc-tubing-material-of-a-heart-lung-machine
#19
Elisabeth Eckert, Frank Münch, Thomas Göen, Ariawan Purbojo, Johannes Müller, Robert Cesnjevar
Medical devices like blood tubing often consist of PVC material that requires the addition of plasticizers. These plasticizers may migrate into the blood leading to an exposure of the patients. In this study the migration behavior of three different blood tubing sets (PVC material with two different plasticizers and silicone as control material) applied on a heart-lung machine standardly used for cardiopulmonary bypass (CPB) in children was studied. We analyzed the total plasticizer migration by analysis of both, the parent compounds as well as their primary degradation products in blood...
February 2016: Chemosphere
https://www.readbyqxmd.com/read/26604296/hypothermic-continuous-machine-perfusion-enables-preservation-of-energy-charge-and-functional-recovery-of-heart-grafts-in-an-ex-vivo-model-of-donation-following-circulatory-death
#20
Olivier Van Caenegem, Christophe Beauloye, Luc Bertrand, Sandrine Horman, Sophie Lepropre, Grégory Sparavier, Jonathan Vercruysse, Noëlla Bethuyne, Alain J Poncelet, Pierre Gianello, Peter Demuylder, Eric Legrand, Gwen Beaurin, Françoise Bontemps, Luc M Jacquet, Jean-Louis Vanoverschelde
OBJECTIVES: Cardiac transplantation using hearts from donors after circulatory death (DCD) is critically limited by the unavoidable warm ischaemia and its related unpredictable graft function. Inasmuch as hypothermic machine perfusion (MP) has been shown to improve heart preservation, we hypothesized that MP could enable the use of DCD hearts for transplantation. METHODS: We recovered 16 pig hearts following anoxia-induced cardiac arrest and cardioplegia. Grafts were randomly assigned to two different groups of 4-h preservation using either static cold storage (CS) or MP (Modified LifePort© System, Organ Recovery Systems©, Itasca, Il)...
May 2016: European Journal of Cardio-thoracic Surgery
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