Localized therapy delivery and local organ protection
A system for perfusing a localized site within a body includes a catheter assembly having a venous access line that is adapted to deliver perfusate to the localized site, a venous or arterial drainage line adapted to drain perfusate from the localized site, and an occlusion device adapted to prevent some or substantially all physiological blood flow between the localized site and the systemic circulation of the body during and in the course of perfusing and draining perfusate to and from the localized site. The system may include a blood circuit associated with the catheter assembly to facilitate blood conditioning for use as the perfusate, in the course of a controlled perfusion and/or drainage of untreated, treated, or inactivated treated blood to and from the localized site. A delivery machine may control the blood circuit and catheter assembly in order to both deliver perfusate to, and drain some or all perfusate from, the localized site in a manner that provides perfusate to substantially only the localized site.
1. A system for delivering localized therapy to a tissue structure, said system comprising:
a venous catheter having a distal portion positionable at a venous drainage structure of said tissue structure, said distal portion including an occlusion device adapted to selectively substantially occlude said venous drainage structure so as to selectively define a tissue structure circulatory compartment distinct from a systemic circulatory compartment, with said tissue structure circulatory compartment being substantially isolated from said systemic circulatory compartment when said occlusion device substantially occludes said venous drainage structure, said venous catheter further including a perfusion port and a drainage port disposed in said tissue structure circulatory compartment, and a systemic port operably disposed in said systemic circulatory compartment; and
a blood conditioning apparatus for supplying conditioned blood to said tissue structure through said perfusion port, and fluidly coupling said drainage port and said systemic port of said venous catheter to one another, said blood conditioning apparatus being capable of treating blood supplied thereto as drainage flow from said drainage port, and dispensing at least a portion of said drainage flow through said systemic port as systemic flow to said systemic circulatory compartment, said blood conditioning apparatus having a plurality of operating modes, with a first operating mode dispensing an entirety of said drainage flow through said systemic port as systemic flow to said systemic circulatory compartment.
2. A system as in claim 1 wherein said blood conditioning apparatus includes a flow divider for controllably separating said drainage flow into said systemic flow and recirculation perfusion flow.
3. A system as in claim 2 wherein a second operating mode of said blood conditioning apparatus dispenses a first portion of said drainage flow through said systemic port as systemic flow to said systemic circulatory compartment, and recirculates a second portion of said drainage flow through said perfusion port as said recirculation perfusion flow to said tissue structure circulatory compartment.
4. A system as in claim 3 wherein a third operating mode of said blood conditioning apparatus recirculates a portion of said drainage flow through said perfusion port as recirculation perfusion flow to said tissue structure circulatory compartment, an entirety of perfusion flow through said perfusion port being said recirculation perfusion flow.
5. A system as in claim 4 , including a perfusion blood source comprising one or more of an external source and a systemic circulatory compartment source.
6. A system as in claim 5 , including a perfusion pump for pumping said perfusion flow through said perfusion port, wherein said perfusion flow is constituted from one or more of said perfusion blood source and said recirculation perfusion flow.
7. A system as in claim 6 wherein treating said systemic flow includes adjusting a temperature of said systemic flow.
8. A system as in claim 7 , including a heat exchanger for adjusting the temperature of said systemic flow.
9. A system as in claim 1 wherein treating said systemic flow includes deactivating said systemic flow.
10. A system as in claim 9 wherein deactivating said systemic flow includes adjusting said systemic flow to a normal physiological temperature.
11. A system as in claim 1 wherein treating said systemic flow includes conditioning said systemic flow for providing therapy to said systemic circulatory compartment.
12. A system as in claim 11 wherein conditioning said systemic flow includes cooling said systemic flow.