Apparatus for maintenance of harvested hearts for transplanting

Abstract

An apparatus, a system, and methods for maintaining and monitoring an excised donor heart. The apparatus comprises a first component for receiving and submerging therein an excised heart in a constantly circulating perfusate solution and a second component comprising equipment for adjusting the temperature and oxygen content of the perfusate solution. The first component comprises an integral pair of defibrillating pads. A first conduit infrastructure interconnects the first module, the second module and an aorta of the excised donor heart pushing a perfusion solution from the first module through the second module into the aorta. The second conduit infrastructure connects the first module with the right atrium and the left atrium for pushing the perfusion solution from the first module into the atria. The third conduit infrastructure connects the first module with the pulmonary artery and provides an after pressure to the flow of the perfusion solution from the pulmonary artery.

1 . A portable system for perfusing excised donor hearts, comprising:
 a first module and a second module;   a first pump, a second pump, and a third, bi-directional pump;   a plurality of conduits for interconnecting the first and second modules and the first, second and third pumps;   a computer providing computer-controlled modulation of the third pump; and   a transportable support configured for disengagably mounting thereon the first module, and for mounting thereon the second module, the first, second and third pumps, the plurality of conduits, and a reservoir of a perfusate;   wherein   the first module comprises a removable support for supporting an excised heart and conduits for connecting the excised heart to the reservoir;   the second module comprises a heat-exchanger and an oxygenator for conditioning the perfusate;   the plurality of conduits comprises a first conduit for connecting with an aorta of the heart, a second conduit for connecting with an atrium of the heart, and a third conduit for connecting with a pulmonary artery of the heart;   the first pump is in communication with the first conduit;   the second pump is in communication with the second conduit;   the third pump is in communication with the third conduit; and   the third pump is configured and the computer is programmed to modulate the third pump operable to apply an afterload pressure in the third conduit at the pulmonary artery to resist a flow of the perfusate in the third conduit from the pulmonary artery.   
     
     
         2 . The portable system of  claim 1 , wherein at least one of the first, second and third pumps is a centrifugal pump. 
     
     
         3 . The portable system of  claim 1 , wherein the transportable support comprises a housing for the first and second modules, the first, second and third pumps, and the plurality of conduits. 
     
     
         4 . The portable system of  claim 1 , further comprising an ECG monitoring device and a cardiac pacemaker. 
     
     
         5 . The portable system of  claim 1 , further comprising a pair of defibrillator pads mounted in the first module, and a defibrillator for communicating with the pair of defibrillator pads. 
     
     
         6 . The portable system of  claim 1 , wherein the first pump is configured to apply an afterload pressure to the aorta. 
     
     
         7 . The portable system of  claim 1 , wherein the second pump is connected to the second conduit for applying a preload pressure to the atrium. 
     
     
         8 . The portable system of  claim 1 , wherein the atrium is the left or right atrium of the heart. 
     
     
         9 . The portable system of  claim 1 , comprising the reservoir. 
     
     
         10 . The portable system of  claim 1 , further comprising an occlusion clamp connected with the second conduit for regulating a rate of flow through the second conduit, or modulating a pressure therein. 
     
     
         11 . The portable system of  claim 10 , wherein the occlusion clamp comprises a servo-actuated partial occlusion clamp. 
     
     
         12 . The portable system of  claim 10 , wherein the atrium is the right atrium of the heart. 
     
     
         13 . The portable system of  claim 1 , further comprising flow sensors for monitoring flow rates of the perfusate or measuring pressure in selected ones of the conduits. 
     
     
         14 . The portable system of  claim 1 , further comprising one or more pressure ports in selected ones of the plurality of conduits. 
     
     
         15 . A system for maintenance and assessment of hearts for implantation, comprising:
 a movable base module comprising a first sub-system configured to supply and condition a perfusate;   a perfusion module removably connected to the base module, comprising a second sub-system configured to support a heart and connect the heart for circulating the conditioned perfusate through the heart; and   a control and assessment sub-system connected to the first and second sub-systems and configured to control perfusate flows through the heart and to assess the heart during perfusion, wherein the control and assessment subsystem comprises a computer programed to provide computer-controlled modulation of an afterload pressure applied at a pulmonary artery of the heart to resist a flow of the perfusate egressing from the pulmonary artery.