Implementation of a perfluorocarbon-based artificial oxygen carrier in normothermic porcine heart perfusion

Background

Normothermic machine-perfusion (NT-MP) for organ preservation still depends on perfusates spiked with erythrocytes and thus is limited by donor blood shortage. Perfluorodecalin-based albumin-derived artificial oxygen carriers (A-AOC) display a promising blood alternative. In vitro experiments in cardiomyocytes confirmed the A-AOCs' ability to attenuate ischemia-elicited damage. The aim of this project was to establish a physiological model in which A-AOCs can be tested as blood surrogate.

Methods

NT-MP was chosen as physiological model for testing the functionality of A-AOCs in isolated perfused porcine hearts. Parameters such as oxygen partial pressure, pH-value, level of electrolytes and metabolic parameters of the perfusate were studied by a blood gas analyzer (BGA, ABL 815) and photometry (respons 920).

Results

After first pilot experiments, the perfusion system was successfully built with a heater, a perfusate reservoir, an oxygenator as well as pH- and pO₂-sensors. Preliminary experiments in the established perfusion apparatus showed that the perfusion with a preservation solution was able to maintain a contracting heart for at least one hour. Furthermore, the level of Ca²⁺, K⁺, Na⁺ and lactate as well as oxygen, pH, lactate dehydrogenase and aspartate aminotransferase were successfully monitored throughout the perfusion experiments

Conclusion

After successful establishment of the experimental set-up for perfusing porcine hearts, we can investigate the A-AOCs' potential to reduce ischemia-reperfusion injury (IRI) in an ex vivo heart perfusion. Parameters for IRI (i.g. apoptosis, oxidative stress, Troponin I) will be investigated in the future. Our group previously demonstrated a successful application of A‑AOCs in a Langendorff-perfused rat heart. Therefore, an overall improvement of organ viability is expected for NT-MP with A-AOCs

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