Unloaded-State Heart Perfusion With Left-Ventricle Venting
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Solution Overview
Problem
The demand for heart transplants far exceeds the supply of suitable donor hearts from brain-dead donors, and existing perfusion methods for hearts from donation after circulatory death donors are inadequate due to depleted ATP/ADP levels, necessitating improved systems for organ preservation and viability.
Innovation Solution
A method and system for extracorporeal heart perfusion that maintains the heart in an unloaded state by bypassing the left ventricle, allowing perfusate to exit through the vena cavae, and using a centrifugal pump with an oxygenator to provide oxygenated perfusate without relying on ventricular loading, along with a left ventricle venting arrangement to prevent distention and enable accurate oxygen consumption measurement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If machine perfusion is used to restore ATP/ADP levels in DCD hearts, then organ viability is improved, but system complexity increases
Solution Approach 1:
The system divides the perfusion circuit into distinct functional modules: an organ chamber for heart containment, a pump interface for fluid delivery, and an oxygenator for gas exchange. This segmentation allows each component to perform its specific function efficiently while simplifying the overall system architecture and making the complex perfusion process more manageable and reliable.
Solution Approach 2:
The perfusion system is designed to operate in multiple modes: it can function as a simple oxygenation system, a full perfusion system with pump control, or a combined mode. The pump interface can operate with or without the oxygenator, providing universal functionality that reduces system complexity while maintaining organ viability across different perfusion scenarios.
2Use of energy by moving object
If the heart is kept in an unloaded state during perfusion, then myocardial oxygen consumption is reduced, but maintaining this state requires complex venting arrangements
Solution Approach 1:
The system extracts the left ventricle from the normal perfusion pathway by providing a dedicated venting arrangement that bypasses the left ventricular chamber. This allows the left ventricle to be decompressed and vented separately, maintaining the unloaded state without requiring complex control mechanisms, as the venting pathway is simply opened to allow drainage.
Solution Approach 2:
The venting arrangement acts as an intermediary pathway between the left ventricle and the perfusate reservoir. This mediator component simplifies the system by providing a direct drainage route that prevents left ventricular distention without requiring complex active control systems, thereby reducing myocardial oxygen consumption with minimal added complexity.
3Quantity of substance
If perfusion flow is increased to improve oxygen delivery, then oxygen consumption measurement accuracy deteriorates due to mixing with vented perfusate
Solution Approach 1:
The system segments the perfusate flow paths into distinct channels: one for oxygenated perfusion flow and another for vented flow. By providing separate measurement points and flow paths, the system can accurately measure oxygen consumption in the perfusion stream without contamination from the vented perfusate, even when total flow rates are increased to improve oxygen delivery.
Solution Approach 2:
The venting arrangement serves as an intermediary that separates the measurement function from the oxygen delivery function. By routing vented perfusate through a separate pathway that bypasses the measurement point, the system maintains accurate oxygen consumption measurements while allowing high perfusion flows to improve overall oxygen delivery to the organ.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach reduces myocardial oxygen consumption, allows for improved heart tissue recovery, and extends the preservation time of hearts from donation after circulatory death donors, addressing the shortage of suitable transplant hearts.
Implementation Method 1
providing a pump to transfer pumping force to the pump interface to pump venous perfusate within the first fluid flow path via the oxygenator
Implementation Method 2
pump venous perfusate within the first fluid flow path via the oxygenator to thereby provide subsequent flow of oxygenated perfusate to the heart
Data Source
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AI summary
An organ perfusion system (100) for extracorporeal perfusion of a heart (1) includes an organ chamber (15) having an aortic connector (17), and a first fluid flow path (19) comprising a pump interface (23) and an oxygenator (25), the aortic connector being fluidly connected to the first fluid flow path. The system is adapted for use in a method, wherein oxygenated perfusate is flowed into the heart via the aorta and desoxygenated perfusate is allowed to exit the heart via the inferior vena cava and/or the superior vena cava to thereby perfuse the heart in a substantially unloaded state. Such method may allow for improved recovery of the heart tissue during perfusion. The organ perfusion system may further comprise a perfusate reservoir (27) and/or a chassis, wherein the organ chamber is pivotable with respect to the chassis for holding the heart in a tilted position or to allow rotation of the organ chamber in a horizontal plane.