AUTHOR=Andrijauskaite Kristina , Veraza Rafael J. , Lopez Riley P. , Maxwell Zach , Cano Isabella , Cisneros Exal E. , Jessop Israel J. , Basurto Maria , Lamberson George , Watt Michelle D. , Nespral Joseph , Ono Masahiro , Bunegin Leonid 

TITLE=Novel portable hypothermic machine perfusion preservation device enhances cardiac viability of donated human hearts

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1376101

DOI=10.3389/fcvm.2024.1376101

ISSN=2297-055X

ABSTRACT=Heart transplant remains the gold standard treatment for patients with advanced heart failure. However, the list of patients waiting for a heart transplant continues to increase. We have developed a portable hypothermic oxygenated machine perfusion device, the VP.S ENCORE ® , to extend the allowable preservation time. The purpose of this study was to test the efficacy of the VP.S. ENCORE ® using deceased donors derived hearts. Hearts from brain-dead donors not utilized for transplant (n = 11) were offered for research from the Texas Organ Sharing Alliance (TOSA), South and Central Texas' Organ Procurement Organization (OPO) and were preserved in the VP.S ENCORE ® for 4 (n=2), 6 ( n=3), and 8 (n=3) hours or were kept in static cold storage (SCS) (n = 3). After preservation, the hearts were placed in an isolated heart Langendorff model for reperfusion and evaluated for cardiac function. The mean donor age was 37.82 ± 12.67 with the youngest donor being 19 and the oldest donor being 58 years old. SCS hearts mean weight gain (%) was -1.4 ± 2.77, while perfused at 4 hours was 5.6 ± 6.04, perfused at 6 hours 2.1 ± 6.04, and 8 hours was 7.2 ± 10.76. Venous and arterial lactate concentrations were less than 2.0 mmol/L across all perfused hearts. Left ventricular contractility (+dPdT, mmHg/s) for 4 hours (1214 ± 1064), 6 (1565 ± 141.3), and 8 hours   (1331 ± 403.6)  were within the range of healthy human heart function. Thus, not significant as compared to the SCS group (1597 ± 342.2). However, the left ventricular relaxation (mmHg/s) was significant in 6-hour perfused heart (p < 0.05) as compared to SCS. Gene expression analysis of inflammation markers  showed no significant differences between SCS and perfused hearts, but a 6-hour perfusion led to a downregulated expression of these markers. The results demonstrate that the VP.S ENCORE ® device enhances cardiac viability and exhibits comparable  cardiac function to a healthy heart. The implications of these findings suggest that the VP.S ENCORE ® could introduce a new paradigm in the field of organ preservation, especially for marginal hearts.