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Ex vivo resuscitation and evaluation of hearts after 22 minutes of normothermic cardiac arrest

Steen, Stig LU ; Liao, Qiuming LU ; Pascevivius, Audrius ; Li, Mei LU orcid and Steen, Erik LU (2025) In Scandinavian Cardiovascular Journal 59(1).
Abstract

Objective: The aim was to resuscitate and evaluate hearts ex vivo after 22 min of cardiac arrest with the goal of increasing the number of usable hearts from controlled donation after circulatory death (cDCD). Design: Eight pigs (39–61 kg) underwent 22 min of ventricular fibrillation, after which the heart was first perfused in vivo for three minutes with an oxygenated, erythrocyte-containing cardioplegic preservation solution. The heart was then explanted and perfused ex vivo with the same solution for three hours at 18 °C in a transportable heart preservation system. Functional evaluation was performed ex vivo (n = 7), while one heart underwent orthotopic transplantation and was monitored for 24 h. Results: The seven hearts evaluated... (More)

Objective: The aim was to resuscitate and evaluate hearts ex vivo after 22 min of cardiac arrest with the goal of increasing the number of usable hearts from controlled donation after circulatory death (cDCD). Design: Eight pigs (39–61 kg) underwent 22 min of ventricular fibrillation, after which the heart was first perfused in vivo for three minutes with an oxygenated, erythrocyte-containing cardioplegic preservation solution. The heart was then explanted and perfused ex vivo with the same solution for three hours at 18 °C in a transportable heart preservation system. Functional evaluation was performed ex vivo (n = 7), while one heart underwent orthotopic transplantation and was monitored for 24 h. Results: The seven hearts evaluated ex vivo easily pumped twice the cardiac output measured in vivo. The transplanted heart maintained normal blood pressure, blood gases, and urine output throughout the 24-hour observation period. At the end of this period the aortic pressure was 104/80 mmHg with a heart rate of 129 beats per minute. Intravenous administration of 20, 40, and 100 µg adrenaline resulted in an aortic pressures of 238/171, 284/196, and 287/201 mmHg with corresponding heart rates of 162, 188, and 223 beats per minute. Conclusion: Hearts exposed to 22 min of cardiac arrest were successfully resuscitated ex vivo and demonstrated adequate function when evaluated.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
DCD, evaluation, ex vivo, Heart, NIHP, preservation, transplantation
in
Scandinavian Cardiovascular Journal
volume
59
issue
1
article number
2525098
publisher
Taylor & Francis
external identifiers
  • pmid:40553492
  • scopus:105016607331
ISSN
1401-7431
DOI
10.1080/14017431.2025.2525098
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
id
1e79b415-a1da-40b2-8faf-aea3223e5690
date added to LUP
2025-12-09 15:06:50
date last changed
2025-12-10 03:00:02
@article{1e79b415-a1da-40b2-8faf-aea3223e5690,
  abstract     = {{<p>Objective: The aim was to resuscitate and evaluate hearts ex vivo after 22 min of cardiac arrest with the goal of increasing the number of usable hearts from controlled donation after circulatory death (cDCD). Design: Eight pigs (39–61 kg) underwent 22 min of ventricular fibrillation, after which the heart was first perfused in vivo for three minutes with an oxygenated, erythrocyte-containing cardioplegic preservation solution. The heart was then explanted and perfused ex vivo with the same solution for three hours at 18 °C in a transportable heart preservation system. Functional evaluation was performed ex vivo (n = 7), while one heart underwent orthotopic transplantation and was monitored for 24 h. Results: The seven hearts evaluated ex vivo easily pumped twice the cardiac output measured in vivo. The transplanted heart maintained normal blood pressure, blood gases, and urine output throughout the 24-hour observation period. At the end of this period the aortic pressure was 104/80 mmHg with a heart rate of 129 beats per minute. Intravenous administration of 20, 40, and 100 µg adrenaline resulted in an aortic pressures of 238/171, 284/196, and 287/201 mmHg with corresponding heart rates of 162, 188, and 223 beats per minute. Conclusion: Hearts exposed to 22 min of cardiac arrest were successfully resuscitated ex vivo and demonstrated adequate function when evaluated.</p>}},
  author       = {{Steen, Stig and Liao, Qiuming and Pascevivius, Audrius and Li, Mei and Steen, Erik}},
  issn         = {{1401-7431}},
  keywords     = {{DCD; evaluation; ex vivo; Heart; NIHP; preservation; transplantation}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Cardiovascular Journal}},
  title        = {{Ex vivo resuscitation and evaluation of hearts after 22 minutes of normothermic cardiac arrest}},
  url          = {{http://dx.doi.org/10.1080/14017431.2025.2525098}},
  doi          = {{10.1080/14017431.2025.2525098}},
  volume       = {{59}},
  year         = {{2025}},
}