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首页> 外文期刊>Canadian Journal of Physiology and Pharmacology >Assessment of donor heart viability during ex vivo heart perfusion
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Assessment of donor heart viability during ex vivo heart perfusion

机译：评估离体心脏灌注过程中供体心脏的生存能力

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摘要

Ex vivo heart perfusion (EVHP) may facilitate resuscitation of discarded donor hearts and expand the donor pool; however, a reliable means of demonstrating organ viability prior to transplantation is required. Therefore, we sought to identify metabolic and functional parameters that predict myocardial performance during EVHP. To evaluate the parameters over a broad spectrum of organ function, we obtained hearts from 9 normal pigs and 37 donation after circulatory death pigs and perfused them ex vivo. Functional parameters obtained from a left ventricular conductance catheter, oxygen consumption, coronary vascular resistance, and lactate concentration were measured, and linear regression analyses were performed to identify which parameters best correlated with myocardial performance (cardiac index: mL.min(-1).g(-1)). Functional parameters exhibited excellent correlation with myocardial performance and demonstrated high sensitivity and specificity for identifying hearts at risk of poor post-transplant function (ejection fraction: R-2 = 0.80, sensitivity = 1.00, specificity = 0.85; stroke work: R-2 = 0.76, sensitivity = 1.00, specificity = 0.77; minimum dP/dt: R-2 = 0.74, sensitivity = 1.00, specificity = 0.54; tau: R-2 = 0.51, sensitivity = 1.00, specificity = 0.92), whereas metabolic parameters were limited in their ability to predict myocardial performance (oxygen consumption: R-2 = 0.28; coronary vascular resistance: R-2 = 0.20; lactate concentration: R-2 = 0.02). We concluded that evaluation of functional parameters provides the best assessment of myocardial performance during EVHP, which highlights the need for an EVHP device capable of assessing the donor heart in a physiologic working mode.
机译：离体心脏灌注（EVHP）可能有助于复苏丢弃的供体心脏并扩大供体库;但是，需要一种可靠的方法来证明器官在移植前的生存能力。因此，我们寻求确定可预测EVHP期间心肌功能的代谢和功能参数。为了在广泛的器官功能范围内评估参数，我们从9头正常猪和循环死亡猪后的37捐赠物中获得了心脏，并进行了离体灌注。测量从左心室电导导管获得的功能参数，耗氧量，冠状动脉血管阻力和乳酸浓度，并进行线性回归分析，以确定哪些参数与心肌功能最相关（心脏指数：mL.min（-1）。 g（-1））。功能参数与心肌功能表现出极好的相关性，并显示出高的敏感性和特异性，可识别出存在移植后功能差的风险的心脏（射血分数：R-2 = 0.80，敏感性= 1.00，特异性= 0.85;中风功：R-2 = 0.76，敏感性= 1.00，特异性= 0.77;最小dP / dt：R-2 = 0.74，敏感性= 1.00，特异性= 0.54; tau：R-2 = 0.51，敏感性= 1.00，特异性= 0.92），而代谢参数为预测心肌功能的能力有限（耗氧量：R-2 = 0.28;冠状动脉血管阻力：R-2 = 0.20;乳酸浓度：R-2 = 0.02）。我们得出的结论是，对功能参数的评估可以最好地评估EVHP期间的心肌性能，这突出表明需要一种能够在生理工作模式下评估供体心脏的EVHP设备。

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