Development and Evaluation of Heartbeat: A Machine Perfusion Heart Preservation System

Artif Organs. 2017 Nov;41(11):E240-E250. doi: 10.1111/aor.12867. Epub 2017 Aug 11.

Abstract

Static cold storage is accompanied with a partial safe ischemic interval for donor hearts. In this current study, a machine perfusion system was built to provide a better preservation for the donor heart and assessment for myocardial function. Chinese mini-swine (weight 30-35 kg, n = 16) were randomly divided into HTK, Celsior, and Heartbeat groups. All donor hearts were respectively preserved for 8 hours under static cold storage or machine perfusion. The perfusion solution is aimed to maintain its homeostasis based on monitoring the Heartbeat group. The ultrastructure of myocardium suggests better myocardial protection in the Heartbeat group compared with HTK or Celsior-preserved hearts. The myocardial and coronary artery structural and functional integrity was evaluated by immunofluorescence and Western blots in the Heartbeat. In the Heartbeat group, donor hearts maintained a high adenosine triphosphate level. Bcl-2 and Beclin-1 protein demonstrates high expression in the Celsior group. The Heartbeat system can be used to preserve donor hearts, and it could guarantee the myocardial and endothelial function of hearts during machine perfusion. Translating Heartbeat into clinical practice, it is such as to impact on donor heart preservation for cardiac transplantation.

Keywords: -Machine perfusion; -Organ preservation; Heart transplantation.

MeSH terms

  • Animals
  • Cold Ischemia
  • Cold Temperature
  • Coronary Vessels / drug effects
  • Coronary Vessels / ultrastructure
  • Cytoprotection
  • Disaccharides / pharmacology
  • Electrolytes / pharmacology
  • Energy Metabolism
  • Equipment Design
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / instrumentation*
  • Extracorporeal Membrane Oxygenation / methods
  • Glucose / pharmacology
  • Glutamates / pharmacology
  • Glutathione / pharmacology
  • Heart* / drug effects
  • Heart* / physiopathology
  • Hemofiltration / adverse effects
  • Hemofiltration / instrumentation*
  • Hemofiltration / methods
  • Histidine / pharmacology
  • Mannitol / pharmacology
  • Models, Animal
  • Myocardial Contraction
  • Myocardium / metabolism
  • Myocardium / ultrastructure
  • Organ Preservation / adverse effects
  • Organ Preservation / instrumentation*
  • Organ Preservation / methods
  • Organ Preservation Solutions / pharmacology
  • Perfusion / adverse effects
  • Perfusion / instrumentation*
  • Perfusion / methods
  • Potassium Chloride / pharmacology
  • Procaine / pharmacology
  • Swine
  • Swine, Miniature
  • Time Factors

Substances

  • Bretschneider cardioplegic solution
  • Celsior
  • Disaccharides
  • Electrolytes
  • Glutamates
  • Organ Preservation Solutions
  • Mannitol
  • Histidine
  • Procaine
  • Potassium Chloride
  • Glutathione
  • Glucose