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Machine perfusion heart

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https://www.readbyqxmd.com/read/29744218/machine-perfusion-of-thoracic-organs
#1
REVIEW
Dirk Van Raemdonck, Filip Rega, Steffen Rex, Arne Neyrinck
This article summarizes recent knowledge and clinical advances in machine perfusion (MP) of thoracic organs. MP of thoracic organs has gained much attention during the last decade. Clinical studies are investigating the role of MP to preserve, resuscitate, and assess heart and lungs prior to transplantation. Currently, MP of the cardiac allograft is essential in all type DCD heart transplantation while MP of the pulmonary allograft is mandatory in uncontrolled DCD lung transplantation. MP of thoracic organs also offers an exciting platform to further investigate downregulation of the innate and adaptive immunity prior to reperfusion of the allograft in recipients...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29731238/human-heart-transplantation-from-donation-after-circulatory-determined-death-donors-using-normothermic-regional-perfusion-and-cold-storage
#2
Simon Messer, Aravinda Page, Simon Colah, Richard Axell, Barbora Parizkova, Steven Tsui, Stephen Large
Heart transplantation from donation after circulatory-determined-death (DCD) donors is emerging as an additional avenue to increase heart transplant activity. Previous methods of DCD heart retrieval include direct procurement and cold storage, direct procurement, and machine perfusion and normothermic regional perfusion, followed by machine perfusion during transportation. Herein we report a further technique resulting in successful DCD heart transplantation utilizing normothermic regional perfusion and permitting functional assessment followed by cold storage...
March 30, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29705279/effects-of-subnormothermic-perfusion-before-transplantation-for-liver-grafts-from-donation-after-cardiac-death-a-simplified-dripping-perfusion-method-in-pigs
#3
Y Kakizaki, S Miyagi, K Shimizu, H Kumata, M Matsumura, Y Miyazaki, K Fukuoka, S S Uematsu, K Tokodai, Y Hara, C Nakanishi, M Unno, T Kamei, M Goto
BACKGROUND: Liver transplantation from donors after cardiac death (DCD) provides a solution to the donor shortage. However, DCD liver grafts are associated with a high incidence of primary graft nonfunction. We investigated the effectiveness of subnormothermic porcine liver perfusion, before transplantation from DCD, on graft viability. METHODS: Landrace pigs (25-30 kg) were randomly allocated to 3 groups (5 per group): heart-beating (HB) graft, transplanted after a 4-hour period of cold storage (CS); DCD graft, retrieved 20 minutes after apnea-induced cardiac arrest (respiratory withdrawal) and transplanted after a 4-hour period of CS; and subnormothermic ex vivo liver perfusion (SELP) graft, retrieved in the same manner as the DCD graft but perfused with a subnormothermic oxygenated Krebs-Henseleit buffer (21-25°C, 10-15 cm H2 O) for 30 minutes in a simplified dripping manner, without a machine perfusion system, after the 4-hour period of CS, and subsequently transplanted...
June 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29566990/preserving-and-perfusing-the-allograft-pancreas-past-present-and-future
#4
REVIEW
Shamik Dholakia, Elisabeth Royston, Edward J Sharples, Visesh Sankaran, Rutger J Ploeg, Peter J Friend
The concept of organ preservation by perfusion dates back to the mid-19th century. Innovations since then have included temperature regulation, perfusion fluid composition and various pumping systems. Advances made in liver, heart and kidney machine preservation are now contributing to increased graft utilisation, assessment of graft viability and potentially improved graft survival. Pancreas transplantation has not benefitted to the same extent from the application of perfusion technology, although the need is just as great...
March 6, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29189484/comparison-of-bq123-epoprostenol-and-verapamil-as-vasodilators-during-normothermic-ex-vivo-liver-machine-perfusion
#5
Juan Echeverri, Nicolas Goldaracena, Johan Moritz Kaths, Ivan Linares, Roizar Roizales, Dagmar Kollmann, Matyas Hamar, Peter Urbanellis, Sujani Ganesh, Oyedele A Adeyi, Mahmood Tazari, Markus Selzner, Nazia Selzner
BACKGROUND: The optimal vasodilator to avoid hepatic artery vasospasm during normothermic ex vivo liver perfusion (NEVLP) is yet to be determined. We compared safety and efficacy of BQ123 (endothelin1 antagonist), epoprostenol (prostacyclin analogue), and verapamil (calcium channel antagonist). METHODS: Livers from porcine heart beating donors were perfused for 3 hours and transplanted into recipient pigs. Four groups were compared: group 1, livers perfused with a dose of 1...
April 2018: Transplantation
https://www.readbyqxmd.com/read/29173394/outcome-after-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#6
Simon Messer, Aravinda Page, Richard Axell, Marius Berman, Jules Hernández-Sánchez, Simon Colah, Barbora Parizkova, Kamen Valchanov, John Dunning, Evgeny Pavlushkov, Sendhil K Balasubramanian, Jayan Parameshwar, Yasir Abu Omar, Martin Goddard, Stephen Pettit, Clive Lewis, Anna Kydd, David Jenkins, Christopher J Watson, Catherine Sudarshan, Pedro Catarino, Marie Findlay, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: The requirement for heart transplantation is increasing, vastly outgrowing the supply of hearts available from donation after brain death (DBD) donors. Transplanting hearts after donation after circulatory-determined death (DCD) may be a viable additive alternative to DBD donors. This study compared outcomes from the largest single-center experience of DCD heart transplantation against matched DBD heart transplants. METHODS: DCD hearts were retrieved using normothermic regional perfusion (NRP) or direct procurement and perfusion (DPP)...
December 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29025029/ct-coronary-imaging-a-fast-evolving-world
#7
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
#8
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...
November 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
#9
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...
March 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28705994/wearable-brain-imaging-with-multimodal-physiological-monitoring
#10
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...
March 1, 2018: 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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