Mitochondrial respiratory chain and Krebs cycle enzyme function in human donor livers subjected to end-ischaemic hypothermic machine perfusion.

Introduction: Marginal human donor livers are highly susceptible to ischaemia reperfusion injury and mitochondrial dysfunction. Oxygenation during hypothermic machine perfusion (HMP) was proposed to protect the mitochondria but the mechanism is unclear. Additionally, the distribution and uptake of perfusate oxygen during HMP are unknown.

Hypothermic continuous machine perfusion enables preservation of energy charge and functional recovery of heart grafts in an ex vivo model of donation following circulatory death.

Objectives: Cardiac transplantation using hearts from donors after circulatory death (DCD) is critically limited by the unavoidable warm ischaemia and its related unpredictable graft function. Inasmuch as hypothermic machine perfusion (MP) has been shown to improve heart preservation, we hypothesized that MP could enable the use of DCD hearts for transplantation.

Methods: We recovered 16 pig hearts following anoxia-induced cardiac arrest and cardioplegia.

Hypothermic continuous machine perfusion improves metabolic preservation and functional recovery in heart grafts.

The number of heart transplants is decreasing due to organ shortage, yet the donor pool could be enlarged by improving graft preservation. Hypothermic machine perfusion (MP) has been shown to improve kidney, liver, or lung graft preservation. Sixteen pig hearts were recovered following cardioplegia and randomized to two different groups of 4-hour preservation using either static cold storage (CS) or MP (Modified LifePort© System, Organ Recovery Systems, Itasca, Il).

Impella: a miniaturized cardiac support system in an era of minimal invasive cardiac surgery.

In modern coronary bypass surgery, new objectives have been set based upon a minimal invasive approach: beating heart surgery is the new trend to follow, although this might not be feasible in more complex cases. In these cases, the beating heart could be supported by a mechanical device, preferably a device with minimal invasive features to fit in this new approach. For this purpose, two intravascular blood pumps were developed: the Intracardiac Pump LV for left ventricular support and the Intracardiac pump RV for right ventricular support.