Perfusion module for extracorporeal anti-ischemic protection of a donor heart in experiment

Introduction. Extracorporeal perfusion of transplants is proposed as one of the areas to expand the pool of donor hearts. Important aspects are the establishment of optimal perfusion parameters, which is of particular importance in prolonged perfusion.

Objective. To present the results of the development of a perfusion module for extracorporeal anti-ischemic protection of donor hearts.

Material and methods. A perfusion module for extracorporeal anti-ischemic protection of donor hearts was developed on mature outbred male rats. After 12-hour hypothermic extracorporeal perfusion of the heart in the perfusion module with +8°С oxegenated HTK solution, its function was studied.

Results. In the hypothermic perfusion group on the module, sinus rhythm was observed with a heart rate of 268.5 (256.2;279.0) beats/min; the left ventricle-developed pressure (LVDP) was 65.5 (65.0;70.7) mm Hg, by the end of the 1^st hour, the LVDP was 73.0 (70.5;75.0) mm Hg, after 90 minutes the LVDP was 82.0 (80.5;83.5) mm Hg, by the end of the 2^nd hour, the LVDP was 82.5 (80.5;84.0) mm Hg, which indicated the cardioprotective potential of hypothermic perfusion. The hearts of the control group had sinus bradycardia with a heart rate of 113.5 (90.0;124.7) beats per minute. The LVDP was 27.5 (25.5;30.0) mm Hg by the end of the 30-minute cardiac stabilization period; by the end of the 1^st hour, LVDP was 22.0 (20.5;23.7) mm Hg; by the 90^th minute the contractile function of the hearts was absent, which indicated the development of myocardial damage.

Conclusion. Obtained data indicate that the module can maintain the viability of the donor heart for 12 hours by hypothermic perfusion with +8°С oxygenated HTK solution at flow rate of 0.3 ml/min and pressure of 10 cm H₂O and pO₂ 600-700 mm Hg, which is accompanied by heart rate of 325.0 beats/min and LVDP of 82.5 mm Hg, compared to non-perfusion conservation.

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