Prevention of ischemic myocardial contracture through hemodynamically controlled DCD
(2021) In Cardiovascular Engineering and Technology 12(5). p.485-493- Abstract
- Purpose—Ischemic myocardial contracture (IMC) or ‘‘stoneheart’’ is a condition with rapid onset following circulatory death. It inhibits transplantability of hearts donated uponcirculatory death (DCD). We investigate the effectiveness of hemodynamic normalization upon withdrawal of life-sustaining therapy (WLST) in a large-animal controlled DCD model, with the hypothesis that reduction in cardiac work delays the onset of IMC. Methods—A large-animal study was conducted comprising of a control group (n = 6) receiving no therapy upon WLST, and a test group (n = 6) subjected to a protocol for fully automated computer-controlled hemodynamic drug administration. Onset of IMC within 1 h following circulatory death defined the primary end-point.... (More)
- Purpose—Ischemic myocardial contracture (IMC) or ‘‘stoneheart’’ is a condition with rapid onset following circulatory death. It inhibits transplantability of hearts donated uponcirculatory death (DCD). We investigate the effectiveness of hemodynamic normalization upon withdrawal of life-sustaining therapy (WLST) in a large-animal controlled DCD model, with the hypothesis that reduction in cardiac work delays the onset of IMC. Methods—A large-animal study was conducted comprising of a control group (n = 6) receiving no therapy upon WLST, and a test group (n = 6) subjected to a protocol for fully automated computer-controlled hemodynamic drug administration. Onset of IMC within 1 h following circulatory death defined the primary end-point. Cardiac work estimates based on pressure-volume loop concepts were developed and used to provide insight into the effectiveness of the proposed computer-controlled therapy. Results—No test group individual developed IMC within 1 h, whereas all control group individuals did (4/6 within30 min). Conclusion—Automatic dosing of hemodynamic drugs in the controlled DCD context has the potential to prevent onset of IMC up to 1 h, enabling ethical and medically safe organ procurement. This has the potential to increase the use of DCD heart transplantation, which has been widely recognized as a means of meeting the growing demand for donor hearts. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/f8213bf8-89f8-427e-9f28-d981417111b3
- author
- Wahlquist, Ylva
LU
; Soltesz, Kristian
LU
; Liao, Qiuming LU ; Liu, Xiaofei ; Pigot, Harry LU
; Sjöberg, Trygve LU and Steen, Stig LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Cardiovascular Engineering and Technology
- volume
- 12
- issue
- 5
- pages
- 485 - 493
- publisher
- Springer
- external identifiers
-
- scopus:85105310577
- pmid:33928495
- ISSN
- 1869-408X
- DOI
- 10.1007/s13239-021-00537-8
- project
- Hemodynamic Stabilization
- language
- English
- LU publication?
- yes
- id
- f8213bf8-89f8-427e-9f28-d981417111b3
- date added to LUP
- 2021-03-31 09:12:09
- date last changed
- 2024-05-04 05:05:20
@article{f8213bf8-89f8-427e-9f28-d981417111b3, abstract = {{Purpose—Ischemic myocardial contracture (IMC) or ‘‘stoneheart’’ is a condition with rapid onset following circulatory death. It inhibits transplantability of hearts donated uponcirculatory death (DCD). We investigate the effectiveness of hemodynamic normalization upon withdrawal of life-sustaining therapy (WLST) in a large-animal controlled DCD model, with the hypothesis that reduction in cardiac work delays the onset of IMC. Methods—A large-animal study was conducted comprising of a control group (n = 6) receiving no therapy upon WLST, and a test group (n = 6) subjected to a protocol for fully automated computer-controlled hemodynamic drug administration. Onset of IMC within 1 h following circulatory death defined the primary end-point. Cardiac work estimates based on pressure-volume loop concepts were developed and used to provide insight into the effectiveness of the proposed computer-controlled therapy. Results—No test group individual developed IMC within 1 h, whereas all control group individuals did (4/6 within30 min). Conclusion—Automatic dosing of hemodynamic drugs in the controlled DCD context has the potential to prevent onset of IMC up to 1 h, enabling ethical and medically safe organ procurement. This has the potential to increase the use of DCD heart transplantation, which has been widely recognized as a means of meeting the growing demand for donor hearts.}}, author = {{Wahlquist, Ylva and Soltesz, Kristian and Liao, Qiuming and Liu, Xiaofei and Pigot, Harry and Sjöberg, Trygve and Steen, Stig}}, issn = {{1869-408X}}, language = {{eng}}, number = {{5}}, pages = {{485--493}}, publisher = {{Springer}}, series = {{Cardiovascular Engineering and Technology}}, title = {{Prevention of ischemic myocardial contracture through hemodynamically controlled DCD}}, url = {{https://lup.lub.lu.se/search/files/96270933/soltesz21b.pdf}}, doi = {{10.1007/s13239-021-00537-8}}, volume = {{12}}, year = {{2021}}, }