Apparatus for testing, assessment, and maintenance of harvested hearts for transplanting
An apparatus, a system, and methods for receiving, perfusing and maintaining and assessing excised donor heart physiological functionality. The system generally comprises an apparatus for receiving and holding an excised heart that is interconnected with: (i) a perfusate-processing system, (ii) a bi-directional perfusate pumping system, (iii) flow sensors for monitoring the flow of perfusate to and from an installed heart's aorta, pulmonary artery, pulmonary vein, and vena cava, (iv) an ECG apparatus interconnectable with the installed heart, and (v) probes interconnecting the installed heart with instruments for monitoring the heart's physiogical functionality using load independent indices and load dependent indices.
1. An apparatus for perfusing excised donor hearts, comprising:
a support for supporting an excised donor heart;
a plurality of conduits for connecting a reservoir of a perfusate to the heart supported on the support to circulate the perfusate through the heart, said conduits comprising a first cannula for cannulation into an atrium of the heart, and a second cannula for cannulation into an aorta of the heart;
a servo-actuated partial occlusion clamp connected to the first cannula for automated control of a fluid flow through the first cannula;
an afterload pump in fluid communication with said second cannula, said afterload pump configured and operable to selectively apply an afterload pressure to the aorta to resist circulation of the perfusate through the heart when said clamp is opened to allow the perfusate to enter the atrium through said first cannula; and
a controller in electronic communication with said clamp and said afterload pump, and configured to automatically control operation of said clamp and said afterload pump for regulating circulation of the perfusate through the heart.
2. The apparatus of claim 1 , wherein said pump is a centrifugal pump.
3. The apparatus of claim 1 , wherein the pump is a first pump, and said apparatus comprises a second pump in fluid communication with the atrium through said clamp, for applying a fluid pressure to the atrium.
4. The apparatus of claim 3 , wherein said second pump is a centrifugal pump.
5. The apparatus of claim 1 , wherein said atrium is the right atrium of the heart.
6. The apparatus of claim 1 , wherein said controller comprises a microprocessor.
7. The apparatus of claim 1 , comprising a plurality of flow regulating devices positioned for adjusting perfusate flows in selected ones of said conduits.
8. The apparatus of claim 1 , comprising a temperature sensor positioned for detecting a temperature of the perfusate, and comprising a heat-exchanger for adjusting the temperature of the perfusate.
9. The apparatus of claim 1 , comprising flow sensors positioned for detecting flow rates in selected ones of said conduits.
10. The apparatus of claim 1 , comprising a first pressure sensor positioned for detecting the afterload pressure, and a second pressure sensor positioned for detecting the preload pressure.
11. The apparatus of claim 1 , comprising an oxygenator for controllably adjusting an oxygen content of the perfusate.
12. The apparatus of claim 1 , comprising said reservoir.
13. The apparatus of claim 1 , comprising an electrocardiographic device.
14. The apparatus of claim 1 , comprising a hard-shell container sealingly engagable with the reservoir, wherein said support is removably mounted in the hard-shell container.
15. The apparatus of claim 14 , wherein the reservoir comprises a soft-shell reservoir housed in said hard-shell container, said soft-shell reservoir comprising ports for sealingly engaging and communicating with selected ones of said plurality of conduits.
16. The apparatus of claim 14 , comprising a lid sealably engagable with the hard-shell container, said lid comprising ports for sealably engaging said first cannula and said second cannula.
17. The apparatus of claim 1 , wherein said plurality of conduits comprise a resilient conduit connected to said first cannula, and said clamp clamps around said resilient conduit for regulating flow of the perfusate through said resilient conduit.
18. The apparatus of claim 1 , wherein said plurality of conduits comprises a cannula for cannulation into a pulmonary vein of the heart.