Development of a pulsatile perfusion apparatus for heart preservation with myocardial impedance monitor

带有心肌阻抗监测器的心脏保存脉动灌注装置的研制

• 批准号: 01870059
• 负责人: KANEKO Mitsunori
• 金额: $ 7.62万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Developmental Scientific Research
• 财政年份: 1989
• 资助国家: 日本
• 起止时间: 1989 至 1990
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-01870059/
• 关键词: heart preservation; pulsatile flow; heart transplantation; impedance; 心臓移植; 潅流保存; 低温保存

This study was done to develop a portable perfusion apparatus for heart preservation in which hearts are hypothermically perfused with pulsatile pump for 24 hours and myocardial impedance is continuously measured to assess the myocardial edema. At first we evaluated simple immersion methods for preservation as control with Langendorf using isolated rabbit heart. The left ventricular function after 24 preservation in UW solution was better than in saline and modification at reperfusion, leukocyte depleted terminal cardioplegia, enhanced LV function to sustain the normal circulation after orthotopic heart transplantation in dog. The portable perfusion apparatus with a diaphragm driven by electromagnetic power which derivesd pulsatile flow was made. In vitro test with the apparatus showed 0.05-5ml of stroke volume, 60-120 beat/min, and 15-150 mmHg of perfusion pressure which could be controllable for isolated rabbit heart perfusion. The temperature, however, was difficult to maintain to 10 C during 24 hours perfusion because of the effect of room temperature especially when a "portable" apparatus was desired. Moreover conventional impedance meter should be used at constant temperature and it was proved that the value of tissue impedance at variable temperature was unreliable and worthless.

本研究旨在研制一种便携式心脏保存灌注装置，利用搏动泵对心脏进行低温灌注24 h，连续测量心肌阻抗，评价心肌水肿程度。首先，我们评价了简单的浸泡法保存作为对照与Langendorf使用离体兔心脏。UW液保存24小时后的左室功能优于生理盐水和改良液，再灌注时，去白细胞停搏液能增强左室功能，维持犬原位心脏移植术后的正常循环。研制了一种便携式电磁能驱动隔膜灌注装置，可产生脉动流。离体兔心灌注试验表明，每搏输出量0.05 ~ 5 ml，每分钟心跳60-120次，灌注压15-150 mmHg，可用于离体兔心灌注。然而，由于室温的影响，特别是当需要“便携式”装置时，温度在24小时灌注期间难以保持在10 ℃。此外，传统的阻抗计应在恒温下使用，事实证明，变温下的组织阻抗值不可靠且没有价值。

项目成果

Fukushima N, Nakano S, Shirakura R.: "Effects of terminal cardioplegia with leukocyte-depleted blood on heart graft preserved 24 hours."

Fukushima N、Nakano S、Shirakura R.：“用去白细胞的血液进行末端停搏对保存 24 小时的心脏移植物的影响。”

Shirakura R, Matsuda H, Nakano S, Nakata S, Kaneko M, Miyamoto Y, Matsuwaka R, Kitagawa S, Hukushima N, Kawashima Y.: "cardiac function and myocardial performance of 24 hour preserved asphyxiated canine heart." Ann Thorac Surg.53. 440-4 (1992)

Shirakura R、Matsuda H、Nakano S、Nakata S、Kaneko M、Miyamoto Y、Matsuwaka R、Kitakawa S、Hukushima N、Kawashima Y.：“24 小时保存的窒息犬心脏的心脏功能和心肌性能。”

Shirakura R,Matsuda H,Nakano S,Nakata S,Kaneko M,Miyamoto Y,Matsuwaka R,Kitagawa S,Fukushima N,Kawashima Y.: "Cavdiac function and myocardial performance of 24hour preserved asphyxiated canine heart." Ann Thorac Surg. 53. 440-444 (1992)

Shirakura R，Matsuda H，Nakano S，Nakata S，Kaneko M，Miyamoto Y，Matsuwaka R，Kitakawa S，Fukushima N，Kawashima Y.：“24小时保存的窒息犬心脏的Cavdiac功能和心肌性能。”

Shirakura R, Matsuda H, Nakano S.: "A new method to harvest multiple organs from non-heart-beating donor by use of percutaneous cardiopulmonary supporting machine." Transplantation Proceedings.

Shirakura R、Matsuda H、Nakano S.：“一种利用经皮心肺支持机从无心跳供体中获取多个器官的新方法。”

Fukushima N,Nakano S,Shirakura R.: "Effects of terminal cordioplegia with leukocyte-depleted blood on myocardial ATP of heart preserved 24 hours." Transplantation Proceedings.

Fukushima N，Nakano S，Shirakura R.：“用去白细胞血液进行末端心麻痹对保存 24 小时的心脏心肌 ATP 的影响。”