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Normothermic Ex Vivo Heart Perfusion: Effects of Live Animal Blood and Plasma Cross Circulation

Church, Joseph T.*; Alghanem, Fares*; Deatrick, Kristopher B.; Trahanas, John M.; Phillips, Joseph P.*; Hee Song, Min*; Perkins, Elena M.*; Bartlett, Robert H.*; Rojas-Pena, Alvaro*; Bocks, Martin L.§; Owens, Gabe E.*

doi: 10.1097/MAT.0000000000000583
Biomedical Engineering

Prolonged normothermic ex vivo heart perfusion could transform cardiac transplantation. To help identify perfusate components that might enable long-term perfusion, we evaluated the effects of cross-circulated whole blood and cross-circulated plasma from a live paracorporeal animal on donor porcine hearts preserved via normothermic ex vivo heart perfusion. Standard perfusion (SP; n = 40) utilized red blood cell/plasma perfusate and Langendorff technique for a goal of 12 hours. Cross-circulation groups used a similar circuit with the addition of cross-circulated venous whole blood (XC-blood; n = 6) or cross-circulated filtered plasma (XC-plasma; n = 7) between a live paracorporeal pig under anesthesia and the perfusate reservoir. Data included oxygen metabolism, vascular resistance, lactate production, left ventricular function, myocardial electrical impedance, and histopathologic injury score. All cross-circulation hearts were successfully perfused for 12 hours, compared with 22 of 40 SP hearts (55%; p = 0.002). Both cross-circulation groups demonstrated higher oxygen consumption and vascular resistance than standard hearts from hours 3–12. No significant differences were seen between XC-blood and XC-plasma hearts in any variable, including left ventricular dP/dT after 12 hours (1478 ± 700 mm Hg/s vs. 872 ± 500; p = 0.17). We conclude that cross circulation of whole blood or plasma from a live animal improves preservation of function of perfused hearts, and cross-circulated plasma performs similarly to cross-circulated whole blood.

From the *Extracorporeal Life Support Laboratory, Department of Surgery, University of Michigan, Ann Arbor, Michigan; Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland; Department of Surgery, Columbia University Medical Center, New York, New York; and §Pediatric Interventional Cardiology, UH Rainbow Babies and Children’s Hospital, Cleveland, Ohio.

Submitted for consideration December 2016; accepted for publication in revised form March 2017.

Disclosure: The authors have no conflicts of interest to report. Funding courtesy of the Frankel Family Foundation.

Correspondence: Joseph T. Church, Research Fellow, Extracorporeal Life Support Laboratory, Department of Surgery, University of Michigan, 2110 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109. E-mail: jchurc@med.umich.edu.

Copyright © 2017 by the American Society for Artificial Internal Organs