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Development of an ex vivo technique to achieve reanimation of hearts sourced from a porcine donation after circulatory death model

Mownah, O.A., Khurram, M.A., Kanwar, A., Stamp, S., Rees, D., Brassil, J., Majo, J., Dark, J.H., Carter, Noel and Talbot, D (2014) Development of an ex vivo technique to achieve reanimation of hearts sourced from a porcine donation after circulatory death model. Journal of Surgical Research, 189 (2). pp. 326-334. ISSN 0022-4804

Item Type: Article

Abstract

BACKGROUND:

This study reports on the development of a novel method for achieving ex vivo reanimation of hearts from a porcine donation after circulatory death (DCD) model without the use of donor pretreatment.
METHODS:

Porcine hearts (n = 23) were procured 10-29 min after confirmation of asystole. All hearts underwent initial flush with AQIX RS-I solution (London, UK). A 2-h preservation period followed: group 1 hearts (n1-n11) were preserved using static cold storage, group 2 hearts (n12-n17) were preserved using oxygenated, hypothermic machine perfusion (MP), and group 3 hearts (n18-n23) were subjected to retrograde oxygen persufflation. Reperfusion was performed on a Langendorff modification of a Model 33 Functional Circulation circuit. In hearts n16-n23, a dialysis circuit was incorporated into the circuit to facilitate removal of metabolites. The experimental protocol was allowed to follow an evolutionary course, with the aim of achieving greater success with reanimation.

RESULTS:

In group 1 (static cold storage), 7 of the 11 hearts (63.6%) achieved reanimation on the ex vivo circuit. Two of the six hearts (33.3%) in group 2 (MP) were successfully reanimated. All the six hearts (100%) in group 3 (persufflation) were successfully reanimated. The period of sustained reanimation increased when dialysis was incorporated into the circuit with a maximum of 300 min.

CONCLUSIONS:

Porcine DCD hearts after 29 min of warm ischemia can be reanimated using the method described. A mechanism of reoxygenation (oxygenated MP or coronary sinus oxygen persufflation) during preservation appears mandatory for hearts from DCDs. Persufflation was associated with a higher probability of successful reanimation. Dialysis in the warm phase was useful in removing metabolites that could interfere with reanimation. The results demonstrate the potential of DCDs to counter the decline affecting heart transplantation.

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Depositing User: Hannah Dodd

Identifiers

Item ID: 4946
Identification Number: https://doi.org/10.1016/j.jss.2014.02.041
ISSN: 0022-4804
URI: http://sure.sunderland.ac.uk/id/eprint/4946
Official URL: http://www.journalofsurgicalresearch.com/article/S...

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Catalogue record

Date Deposited: 23 Jun 2014 10:18
Last Modified: 18 Dec 2019 15:37

Contributors

Author: O.A. Mownah
Author: M.A. Khurram
Author: A. Kanwar
Author: S. Stamp
Author: D. Rees
Author: J. Brassil
Author: J. Majo
Author: J.H. Dark
Author: Noel Carter
Author: D Talbot

University Divisions

Faculty of Health Sciences and Wellbeing
Faculty of Health Sciences and Wellbeing > School of Pharmacy and Pharmaceutical Sciences
Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences

Subjects

Sciences > Pharmacy and Pharmacology

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