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Heart Failure pp 223-230 | Cite as

Organ Preservation and Implantation

  • Friedhelm BeyersdorfEmail author
  • Johannes Scheumann
Chapter
Part of the Cardiovascular Medicine book series (CVM)

Abstract

Heart transplantation (HTX) is still the golden standard in the treatment of terminal heart failure. Quality of life after HTX is rated very good and the mid- to long-term results are acceptable. However, organ shortage and chronic transplantation atherosclerosis represent major challenges in this field. Therefore, improvements in organ preservation and implantation are of utmost importance and are described in detail in this report.

Keywords

Heart transplantation Heart preservation Machine perfusion Organ care system Implantation techniques 

References

  1. 1.
    Allen BS, Okamoto F, Buckberg GD, Bugyi H, Young H, Leaf J, Beyersdorf F, et al. Immediate functional recovery after six hours of regional ischemia by careful control of conditions of reperfusion and composition of reperfusate. J Thorac Cardiovasc Surg. 1986;92(3 Pt 2):621–35.PubMedGoogle Scholar
  2. 2.
    Ardahali A, Esmailian F, Deng M, Soltesz E, Hsich E, Naka Y, et al. Ex vivo perfusion of donor hearts for human heart transplantation (PROCEED II): a prospective, open-label, multicentre, randomized non-inferiority trial. Lancet. 2015;385:2577–84.CrossRefGoogle Scholar
  3. 3.
    Astrup J, Siesjö BK, Symon L. Thresholds in cerebral ischemia – the ischemic penumbra. Stroke. 1981;12(6):723–5.CrossRefGoogle Scholar
  4. 4.
    Barnard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. S Afr Med J. 1967;41:1271–4.Google Scholar
  5. 5.
    Beyersdorf F. The use of controlled reperfusion strategies in cardiac surgery to minimize ischaemia/reperfusion damage. Cardiovasc Res. 2009;83:262–8.CrossRefGoogle Scholar
  6. 6.
    Beyersdorf F, Unger A, Wildhirt A, Kretzer U, Deutschländer N, Krüger S, Matheis G, Hanselmann A, Zimmer G, Satter P. Studies of reperfusion injury in skeletal muscle: preserved cellular viability after extended periods of warm ischemia. J Cardiovasc Surg. 1991;32(5):664–76.Google Scholar
  7. 7.
    Buckberg GD. Studies of controlled reperfusion after ischemia. J Thorac Cardiovasc Surg. 1986;92:483–7.PubMedGoogle Scholar
  8. 8.
    Dhital KK, Iyer A, Connellan M, Chew HC, Gao L, Doyle A, et al. Adult heart transplantation with distant procurement and ex-vivo preservation of donor hearts after circulatory death: a case series. Lancet. 2015;385:2585–91.CrossRefGoogle Scholar
  9. 9.
    Dreyfus G, Jebara VA, Couetil JP, Carpentier A. Kinking of the pulmonary artery: a treatable cause of acute right heart failure after heart transplantation. J Heart Transplant. 1990;9:575–6.PubMedGoogle Scholar
  10. 10.
    Eltzschig H, Eckle T. Ischemia and Reperfusion – from mechanism to translation. Nat Med. 2011;17:1391–401.CrossRefGoogle Scholar
  11. 11.
    Emin A, Rogers CA, Banner NR, et al. Quality of life of advanced chronic heart failure: medical care, mechanical circulatory support and transplantation. Eur J Cardiothorac Surg. 2016;50:269–73.CrossRefGoogle Scholar
  12. 12.
    Fellström B. Transplantation atherosclerosis. J Intern Med. 1996;240:253–7.CrossRefGoogle Scholar
  13. 13.
    Garcia Sáez D, Zych B, Sabashnikov A, Bowles CT, de Robertis F, Mohite PN, et al. Evaluation of the organ care system in heart transplantation with an adverse donor/recipient profile. Ann Thorac Surg. 2014;98:2099–105.CrossRefGoogle Scholar
  14. 14.
    Garcia Sáez D, Zych B, Mohite PN, Sabashnikov A, Patil NP, Popov A, et al. LVAD bridging to heart transplantation with an ex-vivo allograft preservation shows significantly improved outcomes: a new standard of care? J Heart Lung Transpl. 2015;34:S95.CrossRefGoogle Scholar
  15. 15.
    Garcia Sáez D, Elbetanony A, Lezberg P, Hassanein A, Bowles CT, Popov AF, et al. Ex-vivo heart perfusion after cardiocirculatory death: a porcine model. J Surg Res. 2015;195:311–4.CrossRefGoogle Scholar
  16. 16.
    Hamed A, Tsui S, Huber J, Lin R, Poggio RC, Ardehali A. Serum lactate is a highly sensitive and specific predictor of postcardiac transplant outcomes using the Organ Care System. J Heart Lung Transpl. 2009;28:S71.CrossRefGoogle Scholar
  17. 17.
    Hossmann KA, Schmidt-Kastner R, Grosse Ophoff B. Recovery of integrative central nervous function after one hour global cerebro-circulatory arrest in normothermic cat. J Neurol Sci. 1987;77(2–3):305–20.CrossRefGoogle Scholar
  18. 18.
    Iyer A, Gao L, Doyle A, Rao P, Cropper JR, Soto C, et al. Normothermic ex vivo perfusion provides superior organ preservation and enables viability assessment of hearts from DCD donors. Am J Transplant. 2015;15:371–80.CrossRefGoogle Scholar
  19. 19.
    Koerner MM, Ghodsizad A, Schulz U, El Baayosy A, Koerfer R, Tenderich G. Normothermic ex vivo allograft blood perfusion in clinical heart transplantation. Heart Surg Forum. 2014;17:E141–5.CrossRefGoogle Scholar
  20. 20.
    Leprince P, Popov AF, Simon AR, Benk C, Siepe M. Ex vivo perfusion of the heart with the use of the Organ Care System. Eur J Cardiothorac Surg. 2016;49:1318–20.CrossRefGoogle Scholar
  21. 21.
    Lower RR, Shumway NE. Studies on the orthotopic homotransplantations of the canine heart. Surg Forum. 1960;11:18–23.PubMedGoogle Scholar
  22. 22.
    Mitrev Z, Beyersdorf F, Hallmann R, Poloczek Y, Ihnken K, Herold H, Unkelbach U, Zimmer G, Freisleben HJ, Satter P. Reperfusion injury in skeletal muscle: controlled limb reperfusion reduces local and systemic complications after prolonged ischaemia. Cardiovasc Surg. 1994;2(6):737–48.PubMedGoogle Scholar
  23. 23.
    Ou R, Lim YW, Choong JW, et al. Low-flow hypothermic crystalloid perfusion is superior to cold storage during prolonged heart preservation. Transplant Proc. 2014;46:3309–13.CrossRefGoogle Scholar
  24. 24.
    Rosenfeldt F, Ou R, Salamonsen R, Marasco S, Zimmet A, Byrne J, Cosic F, Saxena P, Esmore D. A novel combination technique of cold crystalloid perfusion but not cold storage facilitates transplantation of canine hearts donated after circulatory arrest. J Heart Lung Transplant. 2016;35:1358–64.CrossRefGoogle Scholar
  25. 25.
    Sarsam MA, Campbell CS, Yonan NA, Deiraniya AK, Rahman AN. An alternative surgical technique in orthotopic cardiac transplantation. J Card Surg. 1993;8:344–9.CrossRefGoogle Scholar
  26. 26.
    Schmitto JD, Zimpfer D, Fiane AE, Larbalestier R, Tsui S, Jansz P, Simon A, Schueler S, Strueber M. Long-term support of patients recieving a left ventricular assist device for advanced heart failure: a follow-up analysis of the Registry to Evaluate the HeartWare Left Ventricular Assist System. Eur J Cardiothorac Surg. 2016;50:834–8.CrossRefGoogle Scholar
  27. 27.
    Schnoor M, Schäfer T, Lühmann D, Sievers HH. Bicaval versus standard technique in orthotopic heart transplantation: A systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2007;134:1322–31.CrossRefGoogle Scholar
  28. 28.
    Shumway SJ. Operative Techniques in Heart Transplantation. In: Shumway SJ, Shumway NE, editors. Thoracic Transplantation. Cambridge, MA: Blackwell Science; 1995. p. 163–73.Google Scholar
  29. 29.
    Sievers HH, Weyand M, Kraatz EG, Bernhard A. An alternative technique for orthotopic cardiac transplantation, with preservation of the normal anatomy of the right atrium. Thorac Cardiovasc Surg. 1991;39:70–2.CrossRefGoogle Scholar
  30. 30.
    Sjostrand F, Allen BS, Buckberg GD, Okamoto F, Young H, Bugyi H, Beyersdorf F, Barnard RJ, Leaf J. Electron microscopic studies: importance of embedding techniques in quantitative evaluation of cardiac mitochondrial structure during regional ischemia and reperfusion. J Thorac Cardiovasc Surg. 1986;92(3 Pt 2):513–24.PubMedGoogle Scholar
  31. 31.
    Taunyane IC, Benk C, Beyersdorf F, et al. Preserved brain morphology after controlled automated reperfusion of the whole body following normothermic circulatory arrest time of up to 20 minutes. Eur J Cardiothorac Surg. 2016;50(6):1025–34.CrossRefGoogle Scholar
  32. 32.
    Tolboom H, Makhro A, Rosser BA, Wilhelm MJ, Bogdanova A, Falk V. Recovery of donor hearts after circulatory death with normothermic extracorporeal machine perfusion. Eur J Cardiothorac Surg. 2015;47:173–9.CrossRefGoogle Scholar
  33. 33.
    Tolboom H, Olejnickova V, Reser D, Rosser B, Wilhelm MJ, Gassmann M, et al. Moderate hypothermia during ex vivo machine perfusion promotes recovery of hearts donated ater circulatory death. Eur J Cardiothorac Surg. 2016;49:25–31.CrossRefGoogle Scholar
  34. 34.
    Trivedi JR, Rajagopal K, Schumer EM, Birks EJ, Lenneman A, Cheng A, Slaughter MS. Differences in status 1A heart transplantation survival in the continuous flow left ventricular assist device era. Ann Thorac Surg. 2016;102:1512–6.CrossRefGoogle Scholar
  35. 35.
    Van Caenegem O, Beauloye C, Bertrand L, Horman S, Lepropre S, Sparavier G, et al. Hypothermic continuous machine perfusion enables preservation of energy charge and functional recovery of hearts grafts in an ex vivo model of donation following circulatory death. Eur J Cardiothorac Surg. 2016;49:1348–53.CrossRefGoogle Scholar
  36. 36.
    Warnecke G, et al. Organ Care System (OCS) Lung INSPIRE International Trial Results (abstract OLB05). Transplan Int. 2015;28(Suppl):131.3–4.Google Scholar
  37. 37.
    Yeung JC, et al. Outcomes after transplantation of lungs preserved for more than 12 h: retrospective study. Lancet Respiratory Med. 2016;5:119–24.  https://doi.org/10.1016/S2213-2600(16)30323-X.CrossRefGoogle Scholar
  38. 38.
    Zimpfer D, Netuka I, Schmitto JD, Pya Y, Garbade M, Moshuis M, Beyersdorf F, Marasco S, Rao V, Damme L, Sood P, Krabatsch T. Multicentre clinical trial experience with the HeartMate 3 left ventricular assist device: 30-day outcomes. Eur J Cardiothorac Surg. 2016;50:548–54.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryUniversity Heart Center FreiburgFreiburgGermany

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