The design and build of a portable heart preservation device to improve the retrieval of organs for transplantation

Abstract

Heart failure is a serious health condition that afflicts millions of people worldwide. For those suffering from end-stage heart biventricular heart failure the only long-term treatment is a heart transplant. Unfortunately, there is an undersupply of donor organs and early graft dysfunction remains a concern. These problems could be reduced if the method traditionally used to preserve the donor heart during transportation was radically changed. Static cold storage has been the standard method of heart preservation for almost 50 years. It is simple and inexpensive. However, it limits the preservation time to 4-6 hours and causes unpredictable levels of myocardial damage. This can lead to poor outcomes and high post-operative healthcare costs. A system is required that will better preserve the functionality of the donor heart and for much longer time periods. Researchers have trialled techniques aimed at preserving hearts using oxygenated perfusion of the coronary arteries for many years. The lack of a portable version of the ex vivo heart perfusion systems led to the continued use of static cold storage. The Transmedics Organ Care System is now commercially available to provide portable perfusion preservation of donor hearts. The device has passed clinical trials and has been used in hundreds of procedures worldwide. However, the high cost of the Transmedics circuits have prohibited its routine use. In addition, there are no portable ex vivo heart perfusion devices available for carrying out research studies to determine the optimum perfusion preservation conditions for hearts and the different organs required for transplant surgery. This project aimed to design and build a portable heart perfusion device which could be used for research studies. The device was built from components currently available for use in cardiopulmonary bypass circuits to keep it low cost. The device was also designed to be flexible enough to preserve a range of different organs. The portable ex vivo heart perfusion system also included the facility to convert from preservation mode into a test mode. The test mode allowed the isolated heart to undergo haemodynamic testing by measuring the cardiac output. Large mammalian animal hearts were sourced to help develop the laboratory system and then to test the completed portable device.

Date of Award	1 Aug 2018
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Nizar Yonan (Supervisor) & James Fildes (Supervisor)