title: Normothermic Ex Vivo Heart Perfusion: Effects of Live Animal Blood and Plasma Cross Circulation.
abstract: 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.
authors.affiliation: 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.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Church
authors.forename: Fares
authors.initials: F
authors.lastname: Alghanem
authors.forename: Kristopher B
authors.initials: KB
authors.lastname: Deatrick
authors.forename: John M
authors.initials: JM
authors.lastname: Trahanas
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Phillips
authors.forename: Min
authors.initials: M
authors.lastname: Hee Song
authors.forename: Elena M
authors.initials: EM
authors.lastname: Perkins
authors.forename: Robert H
authors.initials: RH
authors.lastname: Bartlett
authors.forename: Alvaro
authors.initials: A
authors.lastname: Rojas-Pena
authors.forename: Martin L
authors.initials: ML
authors.lastname: Bocks
authors.forename: Gabe E
authors.initials: GE
authors.lastname: Owens
mesh_terms: D000818:Animals; D003427:Cross Circulation; D016027:Heart Transplantation; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods*; D010949:Plasma; D013552:Swine; D014655:Vascular Resistance