Document Detail


Myocardial perfusion characteristics during machine perfusion for heart transplantation.
MedLine Citation:
PMID:  18656629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Optimal parameters for machine perfusion preservation of hearts prior to transplantation have not been determined. We sought to define regional myocardial perfusion characteristics of a machine perfusion device over a range of conditions in a large animal model. METHODS: Dog hearts were connected to a perfusion device (LifeCradle, Organ Transport Systems, Inc, Frisco, TX) and cold perfused at differing flow rates (1) at initial device startup and (2) over the storage interval. Myocardial perfusion was determined by entrapment of colored microspheres. Myocardial oxygen consumption (MVO(2)) was estimated from inflow and outflow oxygen differences. Intra-myocardial lactate was determined by (1)H magnetic resonance spectroscopy. RESULTS: MVO(2) and tissue perfusion increased up to flows of 15 mL/100 g/min, and the ratio of epicardial:endocardial perfusion remained near 1:1. Perfusion at lower flow rates and when low rates were applied during startup resulted in decreased capillary flow and greater non-nutrient flow. Increased tissue perfusion correlated with lower myocardial lactate accumulation but greater edema. CONCLUSIONS: Myocardial perfusion is influenced by flow rates during device startup and during the preservation interval. Relative declines in nutrient flow at low flow rates may reflect greater aortic insufficiency. These factors may need to be considered in clinical transplant protocols using machine perfusion.
Authors:
Matthias Peltz; Michael L Cobert; David H Rosenbaum; LaShondra M West; Michael E Jessen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  144     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center at Dallas, TX 75390-8879, USA.
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MeSH Terms
Descriptor/Qualifier:
Alanine / metabolism
Animals
Aortic Valve / surgery
Blood Flow Velocity
Coronary Circulation*
Dogs
Heart*
Heart Transplantation*
Lactic Acid / metabolism
Microspheres
Myocardium / metabolism
Organ Preservation*
Organ Preservation Solutions
Organ Size
Oxygen Consumption
Chemical
Reg. No./Substance:
0/Organ Preservation Solutions; 50-21-5/Lactic Acid; 56-41-7/Alanine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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