Enhancing Metabolism of Donor Hearts for Cardiac Transplantation
type: CreativeWork
description: Congestive heart failure is a major health problem that affects millions of patients and represents a major cost to the health care system. Heart transplantation remains the most effective treatment for end-stage heart failure. However, transplantation can only be offered to a small fraction of patients with this disease due to the inadequate supply of available organs. A major factor limiting the donor pool relates to the poor ischemic tolerance of hearts removed and stored prior to implantation. Currently used heart preservation techniques involve storage of the organ near 0ºC to minimize donor organ metabolism and limit ongoing deterioration of the organ during storage prior to implantation (static storage). A new technique (machine perfusion preservation) is under development and works by perfusing the organ with oxygenated preservation solution. This method may extend the donor ischemic interval and may permit utilization of less-than-optimal donor hearts - thus expanding the donor pool for cardiac transplantation. This strategy has been used successfully for kidney transplantation in the clinical arena and initial experimental evidence suggests that it appears promising for preserving hearts as well. However, optimal myocardial perfusion conditions and techniques have not yet been defined. In fact, available preservation solutions do not contain substrates that are metabolized by the heart and available perfusion devices do not reliably deliver oxygen and substrates to the capillary bed. We believe that optimizing machine perfusion conditions in a manner designed to increase cardiac metabolism will improve the support of cellular processes, improve donor heart preservation, and potentially reverse myocardial injury sustained during the events leading to brain death. We have examined methods to optimize metabolism in two ways. First, we identified substrates which, when added to the circulating preservation solution, maximize myocardial metabolism. Our initial …
abstract: Congestive heart failure is a major health problem that affects millions of patients and represents a major cost to the health care system. Heart transplantation remains the most effective treatment for end-stage heart failure. However, transplantation can only be offered to a small fraction of patients with this disease due to the inadequate supply of available organs. A major factor limiting the donor pool relates to the poor ischemic tolerance of hearts removed and stored prior to implantation. Currently used heart preservation techniques involve storage of the organ near 0ºC to minimize donor organ metabolism and limit ongoing deterioration of the organ during storage prior to implantation (static storage). A new technique (machine perfusion preservation) is under development and works by perfusing the organ with oxygenated preservation solution. This method may extend the donor ischemic interval and may permit utilization of less-than-optimal donor hearts - thus expanding the donor pool for cardiac transplantation. This strategy has been used successfully for kidney transplantation in the clinical arena and initial experimental evidence suggests that it appears promising for preserving hearts as well. However, optimal myocardial perfusion conditions and techniques have not yet been defined. In fact, available preservation solutions do not contain substrates that are metabolized by the heart and available perfusion devices do not reliably deliver oxygen and substrates to the capillary bed. We believe that optimizing machine perfusion conditions in a manner designed to increase cardiac metabolism will improve the support of cellular processes, improve donor heart preservation, and potentially reverse myocardial injury sustained during the events leading to brain death. We have examined methods to optimize metabolism in two ways. First, we identified substrates which, when added to the circulating preservation solution, maximize myocardial metabolism. Our initial …
author: Cobert, Michael Louis
language: en
keywords: Organ Preservation Solutions, Edema, Cardiac, Heart Transplantation
date published: 2012-07-10T15:50:52Z
date modified: 2026-07-24T05:52:06Z
provider: University of Texas Southwestern Medical Center
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Texas Southwestern Medical Center

PropertyValue
property ID: Handle
value: https://hdl.handle.net/2152.5/992