Systems and methods for ex-vivo organ care
The disclosure provides, in various embodiments, systems, devices and methods relating to ex-vivo organ care. In certain embodiments, the disclosure relates to maintaining an organ ex-vivo at near physiologic conditions. In certain embodiments, the disclosure relates to testing properties of an ex-vivo heart or an organ care system, adjusting a property of the organ care system in response to certain results of the testing, and re-testing the ex-vivo heart or the organ care system. In certain embodiments, the disclosure relates to synchronizing at least one cycle of a pumping of a perfusion fluid with a state of the ex-vivo heart.
1. A method comprising:
placing an ex-vivo heart in a chamber of an organ care system;
connecting the ex-vivo heart to a perfusion fluid circuit of the organ care system;
opening an outer lid of the chamber of the organ care system;
examining the ex-vivo heart through a flexible membrane of the organ care system;
initiating a pumping, via the perfusion fluid circuit, of a perfusion fluid to the ex-vivo heart;
synchronizing at least one cycle of the pumping of the perfusion fluid with an r-wave of the ex-vivo heart;
testing the ex-vivo heart or the organ care system;
adjusting a property of the organ care system in response to a result of the testing ef the ex-vivo heart or the organ care system; and
after adjusting the property of the organ care system in response to the result of the testing the ex-vivo heart or the organ care system, re-testing the ex-vivo heart or the organ care system.
2. The method of claim 1 , wherein testing the ex-vivo heart comprises performing, on the ex-vivo heart, a pressure volume loop evaluation.
3. The method of claim 1 , wherein adjusting the property of the organ care system comprises selecting the property of the organ care system from the group consisting of a fluid-flow rate of the perfusion fluid, a pressure of the perfusion fluid, or a temperature of the perfusion fluid.
4. The method of claim 1 , wherein adjusting the property of the organ care system comprises applying, via one or more electrodes positioned between the ex-vivo heart and a pad in the organ care system, a defibrillation signal to the ex-vivo heart.
5. The method of claim 1 , comprising:
after re-testing the ex-vivo heart or the organ care system, evaluating the ex-vivo heart for a compatibility with an intended recipient.
6. The method of claim 5 , wherein evaluating the ex-vivo heart for the compatibility with the intended recipient comprises performing, while the ex-vivo heart is connected to the organ care system, a Human Leukocyte Antigen (HLA) matching test on the ex-vivo heart.
7. The method of claim 1 , comprising:
performing, while the ex-vivo heart is connected to the organ care system, a surgical procedure on the ex-vivo heart.
8. The method of claim 1 , comprising:
providing, to the ex-vivo heart, an immunosuppressive treatment, a chemotherapy treatment, a genetic therapy, or an irradiation therapy.
9. The method of claim 1 , comprising:
allowing the ex-vivo heart to remain connected to the perfusion fluid circuit for at least three days.
10. The method of claim 1 , comprising:
after adjusting the property of the organ care system in response to the result of the testing, initiating a pumping of the perfusion fluid in a retrograde flow direction.
11. The method of claim 1 , comprising:
slowing or stopping a retrograde flow of the perfusion fluid; and
after slowing or stopping the retrograde flow of the perfusion fluid, initiating a pumping of the perfusion fluid in a forward direction.
12. The method of claim 11 , wherein initiating the pumping of the perfusion fluid in the forward direction comprises initiating the pumping of the perfusion fluid in the forward direction at a flow rate between about 1 Liter/minute and about 5 Liters/minute.
13. The method of claim 1 , wherein synchronizing at least one cycle of the pumping with the r-wave of the ex-vivo heart comprises timing the pumping such that the perfusion fluid enters the ex-vivo heart when the ex-vivo heart is in a diastolic state.
14. The method of claim 13 , further comprising timing the pumping such that a maximum pump output occurs when the ex-vivo heart is in the diastolic state.
15. The method of claim 1 , wherein:
the pumping occurs in a retrograde flow direction; and
synchronizing at least one cycle of the pumping with the r-wave of the ex-vivo heart comprises initiating a pump cycle at a peak of the r-wave of the ex-vivo heart.
16. The method of claim 1 , wherein:
the pumping occurs in a forward flow direction; and
synchronizing at least one cycle of the pumping with the r-wave of the ex-vivo heart comprises initiating a pump cycle at an offset of the r-wave of the ex-vivo heart.
17. The method of claim 1 , wherein testing the ex-vivo heart comprises performing, on the ex-vivo heart, a blood chemistry analysis.
18. The method of claim 1 , wherein the property of the organ care system is an oxygenation level of the perfusion fluid.
19. The method of claim 1 , wherein the property of the organ care system is a nutrition level of the perfusion fluid.
20. A method comprising:
receiving an ex-vivo heart in a chamber of an organ care system;
opening an outer lid of the chamber of the organ care system;
examining the ex-vivo heart through a flexible membrane of the organ care system;
pumping, via a perfusion fluid circuit of the organ care system, a perfusion fluid to the ex-vivo heart,
synchronizing at least one cycle of the pumping of the perfusion fluid to the ex-vivo heart with an r-wave of the ex-vivo heart;
allowing for testing of the ex-vivo heart or the organ care system;
receiving an adjustment of a property of the organ care system in response to a result of the testing of the ex-vivo heart or the organ care system; and
after receiving the adjustment of the property of the organ care system in response to the result of the testing of the ex-vivo heart or the organ care system, allowing for re-testing of the ex-vivo heart or the organ care system.
21. The method of claim 20 , wherein allowing for testing of the ex-vivo heart or the organ care system comprises allowing for measuring, with respect to the ex-vivo heart, an arterial blood gas level.
22. The method of claim 20 , wherein receiving the adjustment of the property of the organ care system comprises receiving, via one or more electrodes positioned between the ex-vivo heart and a pad in the organ care system, an application of a defibrillation signal to the ex-vivo heart.
23. The method of claim 20 , comprising:
after receiving the adjustment of the property of the organ care system in response to the result of the testing, pumping the perfusion fluid in a retrograde flow direction.
24. The method of claim 20 , comprising:
slowing or stopping a retrograde flow of the perfusion fluid; and
after slowing or stopping the retrograde flow of the perfusion fluid, pumping the perfusion fluid in a forward direction.
25. The method of claim 24 , wherein pumping the perfusion fluid in the forward direction comprises pumping the perfusion fluid in the forward direction at a flow rate between about 1 Liter/minute and about 5 Liters/minute.
26. The method of claim 20 , wherein synchronizing at least one cycle of the pumping with the r-wave of the ex-vivo heart comprises timing the pumping such that the perfusion fluid enters the ex-vivo heart when the ex-vivo heart is in a diastolic state.
27. The method of claim 26 , further comprising timing the pumping such that a maximum pump output occurs when the ex-vivo heart is in the diastolic state.
28. The method of claim 20 , wherein allowing for testing of the ex-vivo heart or the organ care system comprises allowing for measuring, with respect to the ex-vivo heart, a metabolite level.