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Machine perfusion heart

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https://www.readbyqxmd.com/read/27729705/selective-heart-brain-and-body-perfusion-in-open-aortic-arch-replacement
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/26357797/a-2013-survey-on-pressure-monitoring-in-adult-cardiopulmonary-bypass-circuits-modes-and-applications
#11
Laura Rigg, Bruce Searles, Edward Morse Darling
Pressure data acquired from multiple sites of extracorporeal circuits can be an important parameter to monitor for the safe conduct of cardiopulmonary bypass (CPB). Although previous surveys demonstrate that CPB circuit pressure monitoring is widely used, there are very little data cataloging specific applications of this practice. Therefore, the purpose of this study is to survey the perfusion community to catalog 1) primary CPB circuit site pressure monitoring locations; 2) type of manometers used; 3) pressure monitoring interface and servoregulation with pump console; and 4) the rationale and documentation associated with pressure monitoring during CPB...
December 2014: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/26259549/twelve-hour-hypothermic-machine-perfusion-for-donor-heart-preservation-leads-to-improved-ultrastructural-characteristics-compared-to-conventional-cold-storage
#12
Sebastian G Michel, Glenn M La Muraglia, Maria Lucia L Madariaga, James S Titus, Martin K Selig, Evan A Farkash, James S Allan, Lisa M Anderson, Joren C Madsen
BACKGROUND Hypothermic machine perfusion of donor hearts has the theoretical advantage of continuous aerobic metabolism and washes out toxic metabolic byproducts. Here, we studied the effect of hypothermic machine perfusion on cardiac myocyte integrity when hearts are preserved for longer ischemic times (12 hours). MATERIAL AND METHODS Pig hearts were harvested and stored in Celsior® solution for 12 hours using either conventional cold storage on ice (12 h CS, n=3) or pulsatile perfusion with the Paragonix Sherpa Perfusion™ Cardiac Transport System at different flow rates (12 h PP, n=3 or 12 h PP low flow, n=2)...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/26185133/intraoperative-changes-in-cerebrospinal-fluid-gas-tensions-reflect-paraplegia-during-thoracoabdominal-aortic-surgery-a-proof-of-principle-study
#13
Felix Fleissner, Ahmed Redwan, Theodosios Bisdas, Anna-Lena Boeck, Karin Weissenborn, Axel Haverich, Omke E Teebken, Maximilian Pichlmaier, Andreas Martens
BACKGROUND: In this study, gas tensions in cerebrospinal fluid (CSF) were prospectively evaluated as intraoperative markers for the detection of neurological deficits. METHODS: Spinal fluid, serum, and heart lung machine (HLM) perfusate were monitored for gas tensions (po 2/pCo 2) and related parameters (pH, lactate, and glucose) during thoracoabdominal aortic repair and correlated with perioperative neurological examination and electrophysiological testing. RESULTS: Forty-seven patients were assessed for the study, and 40 consecutive patients were finally included...
April 2015: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26044232/the-left-ventricular-assist-effect-and-biocompatibility-study-of-a-novel-para-aortic-counterpulsation-device
#14
C Shi, D-D Zhou, G Liu, L Zhang, J-J Meng, Y Geng, X-G Liu
OBJECTIVE: To evaluate the hemodynamic characteristics and biocompatibility of a new para-aortic counterpulsation device in animal experiment studies. MATERIALS AND METHODS: Para-aortic counterpulsation device (PACD), a monoport device, consists of a blood chamber anastomosed to the descending aorta by means of a valveless graft and an air chamber connected to IABP machine. Hemodynamic parameters during the PACD-assisted beats were compared with those during the unassist beats...
May 2015: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/26007621/normothermic-versus-hypothermic-cardiopulmonary-bypass-in-children-undergoing-open-heart-surgery-thermic-2-study-protocol-for-a-randomized-controlled-trial
#15
Sarah Baos, Karen Sheehan, Lucy Culliford, Katie Pike, Lucy Ellis, Andrew J Parry, Serban Stoica, Mohamed T Ghorbel, Massimo Caputo, Chris A Rogers
BACKGROUND: During open heart surgery, patients are connected to a heart-lung bypass machine that pumps blood around the body ("perfusion") while the heart is stopped. Typically the blood is cooled during this procedure ("hypothermia") and warmed to normal body temperature once the operation has been completed. The main rationale for "whole body cooling" is to protect organs such as the brain, kidneys, lungs, and heart from injury during bypass by reducing the body's metabolic rate and decreasing oxygen consumption...
May 25, 2015: JMIR Research Protocols
https://www.readbyqxmd.com/read/25951569/cardiopulmonary-perfusion
#16
N L Achorn, P C Crawford, M H Bronstein
Open heart surgery is one of the most highly technical of all modern medical techniques, and includes procedures such as coronary artery bypass grafting, cardiac valve repair or replacement, correction of congenital defects, resection of aneurysms, ablation of abnormal pathways of conduction, etc. It relies on the coordinated interaction of a heart surgeon, an anesthesiologist, several nurses and technicians, and a perfusionist. The first successful open heart surgery was performed in Philadelphia forty years ago by Dr...
October 1993: Surgical Technology International
https://www.readbyqxmd.com/read/25936714/application-of-vacuum-assisted-venous-drainage-in-heart-surgeries-for-newborns
#17
Da-wei Xi, Cheng-zhong Yu, Hai-yan Qiu
OBJECTIVE: To explore the role of cardiopulmonary bypass (CPB) with vacuum assisted venous drainage(VAVD)in the management of newborns with congenital heart diseases. METHODS: Total 15 newborns with congenital heart diseases (11 males and 4 females)underwent heart operations. Their age ranged from 2 days to 28 days [mean:(15.67 ± 2.22)days], and their body weight from 2.3 kg to 4.8 kg [mean: (3.75 ± 0.19)kg]. Sternal median incision was made to establish CPB,during which VAVD was applied for all the newborns...
April 2015: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/25740820/moderate-hypothermia-during-ex-vivo-machine-perfusion-promotes-recovery-of-hearts-donated-after-cardiocirculatory-death%C3%A2
#18
Herman Tolboom, Veronika Olejníčková, Diana Reser, Barbara Rosser, Markus J Wilhelm, Max Gassmann, Anna Bogdanova, Volkmar Falk
OBJECTIVES: To establish the optimal machine perfusion temperature for recovery of hearts in a rodent model of donation after declaration of cardiocirculatory death (DCD). METHODS: Hearts from male Lewis rats (n = 14/group) were subjected to 25 min of in situ warm (37°C) ischaemia to simulate DCD. They were then explanted and reperfused with diluted autologous blood for 60 min at 20, 25, 30, 33 or 37°C, after which they were stored at 0-4°C in Custodiol preservation solution for 240 min...
January 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/25719899/changing-paradigms-in-organ-preservation-and-resuscitation
#19
REVIEW
Fadwa Ali, Anahita Dua, David C Cronin
PURPOSE OF REVIEW: Shortage of donor organs has increased consideration for use of historically excluded grafts. Ex-vivo machine perfusion is an emerging technology that holds the potential for organ resuscitation and reconditioning, potentially increasing the quality and number of organs available for transplantation. This article aims to review the recent advances in machine perfusion and organ preservation solutions. RECENT FINDINGS: Flow and pressure-based machine perfusion has shown improved kidney graft function and survival, especially among expanded criteria donors...
April 2015: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/25650893/isolated-hepatic-perfusion-as-a-treatment-for-liver-metastases-of-uveal-melanoma
#20
Ilan Ben-Shabat, Christoffer Hansson, Malin Sternby Eilard, Christian Cahlin, Magnus Rizell, Per Lindnér, Jan Mattsson, Roger Olofsson Bagge
Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic agent melphalan. Briefly, the procedure starts with the setup of a percutaneous veno-venous bypass from the femoral vein to the external jugular vein. Via a laparotomy, catheters are then inserted into the proper hepatic artery and the caval vein. The portal vein and the caval vein, both supra- and infrahepatically, are then clamped. The arterial and venous catheters are connected to a heart lung machine and the liver is perfused with melphalan (1 mg/kg body weight) for 60 min...
2015: Journal of Visualized Experiments: JoVE
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