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 physiological functionality using load independent indices and load dependent indices.
1. A perfusion apparatus for pre-transplant maintenance and assessment of an excised donor heart, comprising:
a support for positioning and mounting thereon the excised heart;
a plurality of conduits for communication with a supply of a perfusate, a ventricle of the heart, an atrium of the heart, and the aorta of the heart, wherein the plurality conduits comprises
a first conduit infrastructure for conveying a first portion of the perfusate to the atrium;
a second conduit infrastructure for conveying a second portion of the perfusate to or from the aorta of the heart;
a third conduit infrastructure for conveying a third portion of the perfusate from a pulmonary vein of the heart,
wherein each one of said first, second, and third conduit infrastructures comprises a pump, a flow sensor, and a controllably adjustable clamp for regulating a flow of the perfusate therethrough, the pump of the second conduit infrastructure comprising an afterload pump configured and operable to selectively apply an afterload pressure to the aorta to resist circulation of the perfusate through the heart when the controllably adjustable clamp of the first conduit infrastructure is opened to allow the perfusate to enter the atrium through the first conduit infrastructure, and
wherein the perfusion apparatus further comprises a controller in electronic communication with the controllably adjustable clamp of the first conduit infrastructure and the afterload pump, said controller configured to automatically control operation of the controllably adjustable clamp of the first conduit infrastructure and the afterload pump for regulating circulation of the perfusate through the heart.
2. The apparatus of claim 1 , wherein the controllably adjustable clamp is a servo-actuated partial occlusion clamp.
3. The apparatus of claim 1 , wherein the afterload pump is a centrifugal pump.
4. The apparatus of claim 1 , wherein each one of the pumps is a centrifugal pump.
5. The apparatus of claim 1 , wherein the 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 first pressure sensor positioned for detecting an afterload pressure, and a second pressure sensor positioned for detecting a preload pressure.
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 an oxygenator for controllably adjusting an oxygen content of the perfusate.
10. The apparatus of claim 1 , comprising a reservoir of the perfusate for supplying the perfusate.
11. The apparatus of claim 1 , comprising an electrocardiographic device.
12. The apparatus of claim 1 , wherein said first conduit infrastructure comprises a resilient conduit, and said clamp of the first conduit infrastructure clamps around said resilient conduit for regulating flow of the perfusate through said resilient conduit.