Use of explanted human hearts as a model for the study of cardiac pathophysiologic conditions.
The purpose of this paper is to describe an isolated heart model that uses human hearts to study cardiomyopathy. Techniques of organ preparation and perfusion are described that result in successful restoration of explanted human hearts to a beating condition. Native hearts of transplant recipients were placed on an isolated perfusion circuit immediately after explant. After appropriate organ and circuit preparation these hearts were restored to a functional state. Studies were done to assess the stability over time and response to inotropic stimulation. Six of seven hearts were returned to a functional condition. Left ventricular pressure generation ranged from 56 to 118 mm Hg (mean 84.8 +/- 34.11) at physiologic loading conditions. Hearts remained functional from 67 to 271 minutes (mean 152 +/- 71.7) and retained up to 70% of functional capacity after 120 minutes. Hearts performed in isovolumic and ejecting modes. Hearts had a marked response to inotrope administration not previously described. We conclude that human hearts can be reproducibly restored to a functional condition after explant from transplant recipients and can be maintained in a beating state with reasonably stable pressure generation for an extended period of time, which makes this a useful model with which to study cardiac pathophysiologic conditions. These hearts demonstrate an appropriate response to inotropes not previously observed, most likely because of improved myocardial preservation and stringent control of perfusate chemical make-up.
Slater
J P
JP
College of Physicians and Surgeons, Columbia University, New York, N.Y., USA.
Lipsitz
E C
EC
Chen
J M
JM
Levin
H R
HR
Oz
M C
MC
Burkhoff
D
D
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002118:Calcium / Q000378:metabolism / Q000494:pharmacology; D009202:Cardiomyopathies / Q000503:physiopathology*; D004837:Epinephrine / Q000494:pharmacology; D005260:Female; D006321:Heart / Q000187:drug effects / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006863:Hydrogen-Ion Concentration; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D015425:Myocardial Reperfusion; D010477:Perfusion / Q000379:methods; D011188:Potassium / Q000378:metabolism; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology; D014700:Verapamil / Q000494:pharmacology
D014700:Verapamil; D011188:Potassium; D002118:Calcium; D004837:Epinephrine