Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical SurgeryВестник экспериментальной и клинической хирургии2070-478X2409-143XVoronezh State Medical University named after N.N. Burdenko151610.18499/2070-478X-2022-15-3-214-220Original articlesОригинальные статьиResearch ArticleLong-Term Conditioning of a Donor Heart by AutoperfusionСпособ длительного кондиционирования донорского сердца методом аутоперфузииhttps://orcid.org/0000-0001-7976-596XZhulkovMaksim OlegovychЖульковМаксим Олегович
Russian Federation

Cardiovascular surgeon, MNS of the Research Department of Aortic Surgery, Coronary and Peripheral Arteries of the Institute of Circulatory Pathology

Врач сердечно-сосудистый хирург, мнс научно-исследовательского отдела хирургии аорты, коронарных и периферические артерий института патологии кровообращения

medicus-maligna@mail.ruhttps://orcid.org/0000-0001-6253-9026ZykovIlya SergeevichЗыковИлья Сергеевич
Russian Federation

doctor anesthesiologist of the Federal State Budgetary Institution “National Medical Research Center named after ac. E. N. Meshalkina "Ministry of Health of Russia

врач анестезиолог ФГБУ «НМИЦ им.ак. Е. Н. Мешалкина» Минздрава России

i_zykof@meshalkin.ruhttps://orcid.org/0000-0002-9940-3541SirotaDmitriy АндреевичСиротаДмитрий Андреевич
Russian Federation

PhD, doctor of cardiovascular surgeon, head of the research department of surgery of the aorta, coronary and peripheral arteries of the Institute of Circulatory Pathology

Кандидат медицинских наук, врач сердечно-сосудистый хирург, заведующий научно-исследовательским отделом хирургии аорты, коронарных и периферические артерий института патологии кровообращения

d_sirota@meshalkin.ruhttps://orcid.org/0000-0002-1648-1529AgaevaHava AbdullaevnaАгаеваХава Абдуллаевна
Russian Federation

cardiovascular surgeon, cardiac surgery department of the aorta and coronary arteries

врач сердечно-сосудистый хирург кардиохирургического отделения аорты и коронарных артерий

agaeva_h@meshalkin.ruhttps://orcid.org/0000-0001-8956-6585SabetovAzat KerimbekovichСабетовАзат Керимбекович
Russian Federation

cardiovascular surgeon, cardiac surgery department of the aorta and coronary arteries

врач сердечно-сосудистый хирург кардиохирургического отделения аорты и коронарных артерий

sabetov_a@meshalkon.ruhttps://orcid.org/0000-0001-9956-0056PoveschenkoOlga VladimirovnaПовещенкоОльга Владимировна
Russian Federation

Doctor of Medical Sciences, Head of Laboratory, Federal State Budgetary Scientific Institution "Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences"

Доктор медицинских наук, заведующий лабораторией, Федеральное государственное бюджетное научное учреждение «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»

poveschnko_o@meshalkon.ruhttps://orcid.org/0000-0001-7913-4594BozorovSamandar ShukrulloevichБозоровСамандар Шукруллоевич
Russian Federation

physician resident of the Federal State Budgetary Institution "National Medical Research Center named after ac. E. N. Meshalkina "Ministry of Health of Russia

врач ординатор ФГБУ «НМИЦ им.ак. Е. Н. Мешалкина» Минздрава России

bozorov_s@meshalkin.ruhttps://orcid.org/0000-0001-9113-4204FomichevAlexei VyacheslavovichФомичевАлексей Вячеславович
Russian Federation

MD, PhD, Cardiovascular Surgeon, Cardiac Surgery Department of the Aorta and Coronary Arteries

Кандидат медицинских наук, врач сердечно-сосудистый хирург кардиохирургического отделения аорты и коронарных артерий

a_fomichev@meshalkin.ruhttps://orcid.org/0000-0001-9818-8678ChernyavskyAlexander MikhailovichЧернявскийАлександр Михайлович
Russian Federation

Doctor of Medical Sciences, Professor, Director of the Federal State Budgetary Institution “National Medical Research Center named after Ac. E. N. Meshalkina "Ministry of Health of Russia

Доктор медицинских наук, профессор, директор ФГБУ «НМИЦ им.ак. Е. Н. Мешалкина» Минздрава России

a_cherniavsky@meshalkin.ruFGBU "NMITs named after Academician E. N. Meshalkin" of the Ministry of Health of RussiaФГБУ «НМИЦ им.ак. Е. Н. Мешалкина» Минздрава РоссииFSBI NMITs named after ac. E. N. Meshalkina "Ministry of Health of RussiaФГБУ «НМИЦ им.ак. Е. Н. Мешалкина» Минздрава РоссииFederal State Budgetary Scientific Institution "Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences"Федеральное государственное бюджетное научное учреждение «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»290920221532142202406202101082022Copyright ©; 2022, Voronezh N.N. Burdenko State Medical UniversityCopyright ©; 2022, ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России2022Voronezh N.N. Burdenko State Medical UniversityФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава Россииhttps://vestnik-surgery.com/journal/about/editorialPolicieshttps://vestnik-surgery.com/journal/article/view/1516

The aim of research was to study parameters of homeostasis and conditions for stable operation of the autoperfused heart-lung complex ex vivo.Materials and methods. A series of acute experiments (n-3) was carried out to create a functioning heart-lung complex and study parameters of homeostasis ex vivo. A large mammal (mini-pig weighed 20-30 kg) was used as an experimental model. During the experiment, invasive blood pressure in the aortic root, pulmonary artery, central venous pressure, temperature of the left ventricle of the heart, gas composition of arterial blood (in the aortic root) and venous blood flowing from the coronary sinus was monitored.Results. The series of experiments evidenced the fundamental possibility of an isolated heart-lung complex ex vivo stable functioning. During 4-hours autoperfusion of the "heart-lung" complex, the parameters of hemodynamics, gas and biochemical blood composition remained within the reference values.Conclusion. The analysis of literature data and the results of experiments on laboratory animals allow us to state that the autoperfusion can be successfully used as an option of safe and long-term conditioning of a donor heart. This technique can be used to improve the results of heart transplantation with prolonged ischemia of the donor organ. Extending the survival of a donor heart ex vivo functioning will significantly expand the geography of donor bases, reducing the ischemic period to a minimum.

Цель. Изучить параметры гомеостаза и условия стабильной работы аутоперфузируемого комплекса «сердце-легкие» ex vivo.

Материалы и методы. Для создания работающего комплекса «сердце-легкие» и изучения параметров гомеостаза ex vivo была проведена серия острых экспериментов (n-3). В качестве экспериментальной модели использовали крупное млекопитающее (mini-pig весом 20-30 кг). Во время эксперимента проводили мониторинг инвазивного артериального давления в корне аорты, легочной артерии, центрального венозного давления, температуры левого желудочка сердца, газового состава артериальной крови (в корне аорты) и венозной крови, оттекающей из коронарного синуса.

Результаты. В ходе проведенной серии экспериментов была доказана принципиальная возможность стабильной работы изолированного комплекса «сердце-легкие» ex vivo. На протяжении 4 часов аутоперфузии комплекса «сердце-легкие» параметры гемодинамики, газового и биохимического состава крови оставались в пределах референтных значений.

Заключение. Проведенный анализ литературных данных и результаты экспериментов на лабораторных животных позволяют утверждать, что метод аутоперфузии может успешно применяться как способ безопасного и длительного кондиционирования донорского сердца. Данный метод может быть использован для улучшения результатов трансплантации сердца с длительной ишемией донорского органа. Продление дожития функционирующего донорского сердца ex vivo позволит значительно расширить географию донорских баз, сократив ишемический период до минимума.

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