In 3 sentences: This document summarizes an experiment aiming to develop an ex-vivo slaughterhouse model for resuscitating pig hearts using the Langendorff technique. The experiment tested different perfusion and cardioplegia conditions on isolated pig hearts over multiple trials to optimize contractile function recovery, heart rate, and ECG recordings. The best results were obtained using streptokinase and heparin in the cardioplegia solution, with some hearts maintaining atrial conduction for up to 30 minutes and heart rates up to 160 bpm after resuscitation.

1. EX-VIVO SLAUGHTERHOUSE
PORCINE CRYSTALLOID-PERFUSED
BEATING HEART VIA LANGENDORFF
METHOD
By: Rahiemin Talukder
Advisor: Dr. Ali N. Azadani
UC Denver Biology BS
University of Denver ENBI Bioengineering MS
MME Department
1

2. PRESENTATION STRUCTURE
 Introduction and
Background
 Heart Transplantation
 Anatomy
 Physiology
 Langendorff system
 Preservation
 Hypothermia
 Reperfusion
 Previous Studies
 Materials and Methods
 Harvesting
 Preservation
 Resuscitation
 Results
 Discussion
 Additives, Limitations
 Future Research
Developments
 Conclusion
2

3. ORGAN TRANSPLANTATION
Figure 1 – OrganDonor.gov Organ donors and
recipients and in-waiting in the US[2]
3
Roughly 29,000
transplantations
were performed in
2014.
3,965 are
awaiting
heart transplants.
In 2014,
2174 heart
transplants
were performed
in the US.

4. BACKGROUND
4

5. HEART ANATOMY
5
Figure 2 - Standard anatomy of the heart with
deoxygenated blood from body circulation towards the
lungs on the right side of heart and oxygenated blood
from lungs pumped towards systemic circulation[15]

6. CORONARY CIRCULATION OF THE HEART
Figure 3- anatomy of coronary circulation of
arterial (left) and venous (right) vessels [11]
As the heart works in vivo, coronary flow occurs during ventricular
diastole periods
6

7. CARDIAC CELL MEMBRANE PHYSIOLOGY
 Table 2 – average
extracellular vs intracellular
composition[13]
Ion Equilibrium
Potential
Potassium -90 mV
Sodium +67 mV
Calcium +123 mV
Chloride -86 mV
Table 3 – Equilibrium potential of core
ions in cell [13]
Extracellular
concentration
(mM)
Intracellular
concentration (mM)
Na+
K+
Ca2+
Cl-
Mg2+
ATP
glucose
145
4
1
110
1.5
0
5.6
15
150
4
10
17
4
1
7

8. ACTION POTENTIAL
Fast response
Photo Credit: http://www.pathophys.org/physiology-of-cardiac-
conduction-and-contractility
Figure 5 – (left) Action potential in myocytes. The fast response organizes near
simultaneous contractions between muscle cells
(right) slow response is carried out by pacemaker cells 8
Figure 4 - Resting membrane
potential Photo credit:
http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/E/ExcitableCells.htmL
Resting state of cell

9. FAST RESPONSE CARDIAC ACTION POTENTIAL
9
Outside cell
Inside cell
Na+ channel Ca2+ channel K+ channel

10. ECG BASED ON GLOBAL ACTION POTENTIAL
Figure 6 Depolarization propagated waves of
both atrial and ventricular function
corresponding into ECG readings using 3
leads on a body. ECG on isolated heart will
differ
Photo credit: (http://www.clicktocurecancer.info/vascular-resistance/cellular-
cardiac-electrophysiology.htmL)
10
Figure 7 - ECG
video with cardiac
electrical
conduction
correspondence

11. ISOLATED HEART PERFUSION
 Langendorff technique
is used to resuscitate
isolated hearts
 Neuronal and hormonal
regulation eliminated
 To have the heart
resuscitated, it must be
preserved and then
reperfused
 This technique is
standard for heart
transplantations Figure 8 – Oscar Langendorff 11
Photo credit: http://iphyspc12.med.uni-rostock.de/hist/langendorff.htm

12. LANGENDORFF TECHNIQUE
Figure 9 - Aortic valve function
and location in aortic root
12
Oxygenated retrograde flow
administered towards the aorta,
causing the aortic valve to shut.
Flow is then redirected towards
the coronary ostia and into the
coronary vasculature, with
unoxygenated venous return
exits out of the coronary sinus
into the right atriumPhoto credit: www.encyclopedia.lubopitko-bg.com

13. LANGENDORFF REPERFUSION MODES
 Brought by pressured
columns and
compliance chamber
 Driven by gravity
 Autoregulation with
oxygen uptake
 Too high pressure can
let on towards edema
 perfusion via roller
pump
Constant Pressure Constant Flow
13

14. PIG AND HUMAN SIMILARITIES
Adult
Human
Adult
Pig
Average body
weight (kg)
62-71 86
Average heart
weight (g)
250-350 358
Resting heart
rate (bpm)
60-100 100 -
150
Average
temperature (C⁰)
37 39
 Similar anatomy of four
chambers, weight, and
orientation
 Xenotransplantation
performed in past but led
to fatal results due to
immunologic responses to
the host body
Table 4 – Human (left) and Pig (right) physiological comparison
14
Photo credit: http://funmozar.com/real-human-heart/

15. PRESERVATION: CARDIOPLEGIA (HEART-PARALYSIS)
15
• Solution that enables electromechanical cardiac
arrest
• Extracellular solutions mimic blood (Na+)
• Intracellular mimics inside cell composition (K+)
• Plegisol is extracellular
• Cost-effective
• UW solution is intracellular and has additives
that increases preservation effectiveness
 osmotic support
 adenosine to increase ATP storage
 antioxidants, etc

16. HYPOTHERMIA/METABOLISM
 Von’t Hoff principle: Oxygen uptake consumption reduces 50%
for every 10C decrease in physiological temperature
 Metabolic rate is decreased, mechanical arrest has occurred and
thus ATP production is ceased and stored
Figure 9 – Logarithmic values displayed for metabolism of endothermic
species with respect to temperature (1000/K) values [55].
16
-10 C60C 20C

17. REPERFUSION
Must be at 37C and pH of 7.4 and oxygenated at 9-11 psi
 Blood
 Red blood cells as oxygen carrier
 must always contain an anti-coagulant.
 Flow rate at 3-4 mL/min/g
 Krebs Henseleit Buffer (KHB)
 Transparent for visual purposes
 Similar to the ionic concentration of blood composed of salts and
glucose
 Direct oxygenation into solution
 Flow rate at 8-12 mL/min/g
 Calcium must be 1-2.5 mM. Too much will cause for less compliancy
due to edema while too less won’t enable contractions
 Diluted blood with KHB
 Many studies take advantage of hemoglobins in red blood cells and
proteins while using KHB at 1:4 blood-KHB
17

18. PREVIOUS STUDIES
18
 These studies show that similar cases are
working for 4 hours with oxygenated
reperfusion at 37C
 Discover missing points from patents of previous
studies enable us to discover how to develop a
working Langendorff system at DU

19. EINDHOVEN UNIVERSITY OF TECHNOLOGY LIFETEC
BIOHEART
 Slaughterhouse pigs are used
 Reperfusion: Mixed KHB and
filtered heparinized blood
collected from another pig.
Hematocrit at 25%
 3 L circulating perfusate
 Hearts resuscitated for 4
hours with stabilized sinus
rhythm
19

20. PRELIMINARY STUDIES – VISIBLE HEART LAB
[33]
 Langendorff schematic of
the Visible Heart Lab
pertaining human and pig
hearts [27]
 Heart is excised in lab;
transport & set-up time 5
minutes
 Rewarming stage is 30
minutes
 Crystalloid perfusion only
 Video and camera quality
image due to transparent
solution
 Work was patented and
not all details provided
providing us to discover
and fill in the gaps
20

21. MATERIAL AND METHODS
21
• Harvesting
• Preservation
• Reperfusion

22. HARVESTING
 120-kg swine of Yorkshire,
Berkshire, and Hampshire breed
are brain-dead and
exsanguination occurs, starting
warm ischemic time (WIT).
 WIT is kept 1.5 minutes – 7
minutes. WIT is detrimental to
heart survival. Other
slaughterhouses had longer WIT
 Excised hearts must be beating
so that cardioplegia is the factor
that arrests and not cell death
 WIT ends when cold ischemia is
initiated by hypothermic topical
saline with ice slurry to wash all
blood
22
Figure 10 – Trimming tissue
from excised heart

23. PRESERVATION
 Cannula is inserted, tied,
and clamped into aorta
 1-L of 4C cardioplegia
coronary flush enables aortic
valve shut for solution to
redirect towards coronary
vasculature
 Aortic valve must be checked
to be shut
 Heart is placed in sealed
transport bag (1-L 4C UW or
Plegisol) submerged in ice
 1-hour Transport time
 Cold ischemia lasts 1.5-2
hours
23
 Figure 11 – Cannulated heart
with aortic valve shut under 72
mmHg

24. CORONARY CATHETERIZATION
Figure 14 – DLP®/Gundry ® Retrograde Coronary Sinus
Perfusion cannula with manual-Inflate Cuff
Figure 13 – Medtronic DLP ®
Multiple Perfusion Set
24
Figure 12 – Cannula insert

25. APPARATUS
25
 Millipure water for buffers and cleaning
 7 L modified Krebs Henseleit Buffer
 2.1 g/L Sodium bicarbonate
 Calcium chloride dihydrate (1.5-2.5
mMol/L)
 Mannitol (2.92 g/L )
 Heparin (5K-15K/L )
 Insulin (10 U/L)
 20KU Streptokinase/heart
 Epinephrine (0.25 mL/L)
 Carbogen tank for oxygenation and
carbon dioxide to stabilize pH to 7.4 at
9-11 psi
 Water heater
 Perfusion chamber
 Pressure transducer
 Air bubble trap
 Thermometer gun
 ZOLL ® R-series defibrillator and ECG
 Single-Chamber Medtronic pacemaker
Figure 15 – DU Langendorff
schematic

26. RESUSCITATION
 Slow rewarming of heart
before cannulated into
Langendorff system. Most
recently-excised heart is the
first subjected tested to keep
its cold ischemic time as low
as possible
 Defibrillator applied when
arrhythmia occurs at 15-30
Joules, at least 1 minute
intervals
 Pacing at rate 100 ppm,
output at 15 mA, and
sensitivity at 2.5 mV 26Figure 16 – Single Chamber Medtronic
Pacemaker
Photo credit: http://www.m-e-t.co.za/shop/cardiac-rhythm/medtronic-5348-single-chamber-temporary-pacemaker-3/

27. RESULTS
27

28. SETTINGS AND MODIFICATIONS FOR LANGENDORFF-PERFUSED ISOLATED HEARTS
Test Experimen
t Date
Experime
nt heart
test
(n = )
Constant
Flow (CF)
or Constant
Pressure
(CP)
Cardioplegi
a additives
(Heparin
(H) or
Streptokin
ase (SK)
t = 0 hour
(peak avg)
(bpm)
T = 1/2 hour (peak
avg) (bpm)
1 Aug 20 1 CP H 52
(appendage
only)
0
2 CP H 78(append
age only)
0
2 Sept 24 3 CP H 54
(appendage
only)
30
4 CP H 0
3 Oct 8 5 CF H AFib 0
6 CF H N/A 0
4 Feb 16 7 CF H 0
8 CF H 0
5 May 6 9 CF H 86 VF
10 CF H AFib 0
6 July 8 11 CF H & SK N/A 0
12 CF SK N/A 0
28

29. Test Experiment
Date
Experime
nt heart
test
(n = )
Constant
Flow (CF) or
Constant
Pressure
(CP)
Cardioplegi
a additives
(Heparin
(H) or
Streptokina
se (SK)
t = 0 hour
(peak avg)
(bpm)
T = 1/2 hour
(peak avg)
(bpm)
7 Nov 4 13 CF SK 120 0
14 CF SK 30 160
8 Jan 27 15 CF SK 145 79
16 CF SK 0
9 Feb 3 17 CF SK 100 0
18 CF SK 60 0
10 Feb 17 19 CF SK 100-180 0
20 CF SK 150-180 0
11 Mar 24 21 CF SK 176 24
22 CF SK 0 0
12 Mar 31 23 CF SK 143 126
24 CF SK 185 58
13 April 7 25 CF SK 172 110
26 CF SK 147 92
29
SETTINGS AND MODIFICATIONS FOR LANGENDORFF-PERFUSED ISOLATED HEARTS

30. RESULTS
 Results are determined by the following:
 Heart rate mimicking human standards of 60-
120 bpm
 ECG recordings for stabilized QRS complex
 contractile function recovery
 Aortic pressure of 80-120 mmHg
30

31. TEST 1, N = 1
 Heart applied via constant pressure
Langendorff perfusion with cannula
attached towards aorta for n = 1
 Saline was 0-1C
 Plegisol is pH of 3-4
 Appendage beating for only 15
minutes
31
Figure 17
Figure 18

32. TEST 5, N = 9
 Plegisol is modified with
sodium bicarbonate,
stabilizing pH to 7.4 and
activating ingredients
 Atrial contractions occur
before fibrillating.
 Epinephrine is
administered
 Ventricular contraction
not seen due to coronary
blockage
32
Figure 19

33. TEST 5, N = 9
33
Figure 20 - Artery shows KHB
perfusion but other minor
vessels and veins show blood
unable to pass through

34. HEPARIN VS STREPTOKINASE
 Heparin is an
anticoagulant used for
blood and serves for
preventative action
 Streptokinase is a
thrombolytic agent for
thrombi established in
vessels that prevent
coronary flow specifically
in the usage of the heart
Figure 21 (Cossum) Coagulation
pathways of plasma factors
34

35. ENZYMATIC KINETIC ACTIVITY – PH AND TEMPERATURE
Figure 22 a & b –
enzymatic activity effected
by pH and temperature
35

36. TEST 7, N = 13
SK/HEP-INDUCED CARDIOPLEGIA PRESERVATION
 0.176 g CaCl2
 WIT is 6 min
 500 mL of 20KU SK and
15KU heparin –infused
tepid saline flushed prior to
cold cardioplegia
 Constant flow reperfusion
mode
 Pacemaker sensitivity set to
ASYNC to initiate pulse
instead of augmenting SA-
driven pulse
 Atrial conduction for 30 min
 Torsade de Pointes: R on T
is visible
 Ventricular/apical
contraction still not occuring n = 13 initiated global atrial
contraction with HR 30. Atrial
tachycardia approaches before
fibrillation occurs
36
Figure 23

37. TEST 8, N = 15
Figure 24 a & b – ECG readings at key observance of definite
fibrillation with 240 HR, proceeding fibrillation with HR 90, and
observance of polymorphic ventricular tachycardia, Torsade de
Pointes
37
*ECG will not
Follow a regular
3-lead ECG taken
From a human
Body as the heart
Is isolated

38. TEST 8, N = 16
Figure 25 – Fibrillation can
be determined by the second
inclined wave in the QRS
portfolio ( n = 16) and HR 260
Figure 26 dictates the
‘normal’ heart rate due for n =
16
38

39. TEST 11 – PRESSURE TRANSDUCER UTILIZED
Figure 27 – Pressure transducer usage in schematic
39
Figure 28 – Pressure
Transducer and air
trap
*Oscillations due to roller pump.
Mean aortic pressure resided in
80-120 mmHg, following physiological
range

40. MODIFICATIONS FOR TEST 13 PROCEDURE
 Excised beating hearts with lung block intact were
immediately submerged in cold saline.
 WIT 3-4 minutes
 Ostia catheterization of 100 mL 20KU SK-
infused room temperature Plegisol applied at a
time to ensure both arteries had flow
 Waste saline is changed by cold fresh saline
 While tepid cardioplegia in cold saline submergence,
hearts were still beating
 Lab: Reperfusate (KHB) has 2.0 mM CaCl2/L
 *Hearts had highest rate of compliancy than all
previous tests
 Hearts defibrillated at 20 J til stabilized. 0.25 mL/L
Epinephrine is administrated prior to defibrillation
 Needle prick would let air emboli escape from
coronary arteries 40

41. TEST 13, N= 25
Figure 29 – Anterior Langendorff apparatus and set-up for n = 25
41

42. TEST 13
42

43. 43

44. TEST 13, N = 25 ECG
Figure 31 – Vtach at HR 110 (top) and stabilized ECG reading for n =
25 at HR 65 with aortic pressure at 74.7 mmHg
44

45. DISCUSSION
45
• Studies have been done to resuscitate the Langendorff work but
details aren’t always provided. Our lab ran 26 experiments learning
of details not provided
• Modified procedures to increase global contractile function
• HIGHLIGHTS:
• Excised heart is beating
• WIT
• Cooling techniques and changing used saline
• Streptokinase-infused room temperature cardioplegia
• catheterization
• Temperature and rewarming
• Defibrillation until stabilization
• no blood clots
• No air emboli

46. LIMITATIONS
 WIT
 Animal Lab and seeking out
dog hearts at CSU
 Equipment
 Data acquisition
 Pressure-volume
 Left ventricular end-diastole
pressure
 Residing Defibrillator/ECG
 Sterilization (autoclave)
 Apparatus for only 1 heart
at a time (increases CIT for
2nd heart)
 Foam production
 Edema
 Less compliancy
 Leads to organ dysfunction
 Equipment and measurement
of edema to moderate its
significance
46
Figure 32 – Foam accumulation
occurred for all tests

47. ADDITIVES TO LANGENDORFF
 Perfluorocarbons
 Enables improved
oxygen uptake in
crystalloid solutions
mimicking that of
hemoglobins on RBC
 Blood
 To increase oxidation
and protein utilization
aiding cardiac
performance
 Heparin for animal lab
47

48. FUTURE WORKS AS A PLATFORM
 Comparing donor human hearts unable to be
used for transplant to pig hearts
 Collaborating with local hospitals to test original
devices and aid in their studies
 National Jewish Center is interested in testing dog
hearts with MRI. We can use a mobile Langendorff
system
 Anschutz Medical Campus is interested in Ablation
therapy
 Experimentally validate TAV flow and
hemodynamic parameters, and ventricular assist
device testing
48

49. WORKING-HEART MODEL
Chamber Pressure (mmHg)
Preload RA 2-10 mmHg
LA 5-15 mmHg
Afterload RV 10-20
LV 60-80
Table – Loading pressure constants
for cardiac chambers mimicking
physiological values
Figure 33 – Proposed
schematic for
Langendorff/4-chamber
convertible apparatus
49

50. MOBILE LANGENDORFF
 Faster accessibility and usage by eliminating
transport and thus cold ischemic time
 Considerations:
 Oxygen tank
 Electrical outlets
 Sterilized environment and access to all equipment,
water heater
50

51. TRANSMEDIC ORGAN CARE SYSTEM: HEART ™
 Improved patient
outcomes;
 Increased utilization of
available organs;
 Expanded supply of
organs; and
 Reduced total cost of care.
 Key functions:
• Physiological Monitoring
• Blood Oxygenation
• Warming
• Pulsatile Flow
51
Figure 34
Credit: https://www.youtube.com/watch?v=MZxRTYs-dyk

52. CONCLUSION
 Our work’s primarily focus is to utilized the
beating heart platform for vast research in
biomedical device applications and heart
transplantation methods.
 This work is created in hope that it educates a
more-detailed procedure for those seeking to
initiate Langendorff-perfused isolated hearts for
research applications at DU
52

53. RESEARCH ADVENTURES
53

54. THANK YOU!!
Thank you to my committee:
 Dr. James Fogleman, Dr. Matthew Gordon, Dr. Breigh Roszelle, Dr. Ali
Azadani
 Dr. Corinne Lengsfeld, Dr. Mohammad Matin
 Innovative Foods LLC
 Emanual, Pepe, Patti, Diane, and Dave for being flexible, meeting our
research needs and keeping WIT 3-5 min.
 Outreach for aid
 Dr. Dr. Chris Orton at Colorado State University
 Dr. Ashok Babu at Anschutz Medical Center
 Mathieu Poirier and Cory Wagg at University of Alberta
 Ron Richards of President of Rocky Mountain Perfusionists Inc,
 Dr. Balsingham Murugaverl of DU’s chemistry department
 DU’s Professional Research Opportunities for Faculty fund at the University of
Denver.
 Lab Partners: Alex Clinkenbeard & Benjamin Stewart
And always, thank you to my parents and brother Ryan for their sacrifices they’ve
made along with me, keeping me going when I wanted to give up, driving me to work
hard and try first, and do good second.
54

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57

58. Appendix
58

59. ST. THOMAS HOSPITAL #2 (PLEGISOL)
 Plegisol is an efficient cardioplegia with hyperkalemic properties
that mechanically arrests the heart.
 More efficient at higher temperatures compared to other
cardioplegia such as UW solution
 This solution is cost-effective
Table – Composition of Plegisol Solution
59

60. UNIVERSITY OF WISCONSIN (VIASPAN)
UW solution is optimal for long-term
preservation cold storage past 6 hours,
evidently leading to better graft
outcomes
 Potassium lactobionate: Osmotic
support, decrease cell swelling
 KH2PO4: Potassium source
 MgSO4: Desiccant (drying agent on
how water interacts)
 Raffinose: Hypertonicity for cell
desiccation before cooling
 Adenosine: Reduces ATP catabolism
rate, inhibits platelet aggregation &
inflammatory cells, decreases
superoxides, increases contracture
 Glutathione: Reducing agent, oxidizes
free radicals
 Allopurinol: Lowers uric acid in blood
plasma
 Hydroxyethyl starch: Prevents shock
based on blood loss
Table -
60

61. IONIC CONCENTRATIONS OF ALL SOLUTIONS
In Vitro
(mmol)
Plegisol
(extracellula
r)
(mmol)
UW
(Intracellular)
(mmol)
KHB
(extracellular)
(mmol)
In
cell
Out of
cell
Na+ 5-15 150 120 30 142.5
K+ 150 5 16 120 4.4
Cl- 160.4 - 126.7
Ca2+ 10-4 2.5 1.2 - 1.76
Mg2+ 16 5 1.2
H2PO4 - 25 1.2
SO4 - 5 1.2
HCO3 10 - 25
Osmolality 300 315 290
pH 7.8 7.4 7.4
61

62. CALCIUM AND CALCIUM OVERLOAD
 Physiologically, calcium is at 1.4-2.5 mMol/L. However, half
of that is ionized while the other half is bound to protein
which is unavailable in the crystalloid solution
 Calcium overload can lead to noncompliant rigorness due
to:
 Edema – Water is drawn into the mitochondria,
hampering ATP productivity
 High Na+ gradient – as Na+ diffuses abnormally higher
intracellularly, Na+ is pumped back out, and more Ca2+
pumped back in
 Lactate formation
 Reperfusion-induced myocardial injury via oxidative
stress
62

63. STREPTOKINASE DOSAGE IN PATIENTS
Rout
e
Dosage/Duration
I.V.
infusio
n
1,500,000 IU/60
min
I.C.
infusio
n
20,000 IU (bolus)
2,000-4,000 IU/min for
30-90 min (60 min
average)
Table Streptokinase dosage
for IC and IV in clinical
settings
Author Organ Dosage Effect
Szyrach,
2011
Porcine
kidneys
12,500 U/L
vs. 50,000
U/L
50KU led to
toxic effects
Stark, 1988 heart 25000
U/100 mL
Faster
sinus node
recovery
time
Mickelson,
1988
Rabbit
heart
150 U/mL LV function
recovered
and kept
LVEDP
stabilized
Hachenberg
, 2001
Non-heart-
beating
livers
7,5000 U
SK in 20
mL Ringer
solution
Improved
structural
integrity
and
functional
& metabolic
recovery
Table Streptokinase studies on isolated organs
63

64. TIMELINE OF RESEARCH PROGRESSION
 Constant Pressure: Test 1 – 2
 Constant Flow: Test 3 – 13
 Sterilized Plegisol: Test 1 – 5
 Modified Plegisol: Test 5 – 13
 Heparin: Test 1 – 6
 Streptokinase: Test 6 – 13
 UW (Transport Only): Test 2 – 7
 Plegisol (Transport Only): 8 – 13
 Insulin: Test 4 – 6
 Epinephrine: Test 1-6, 9, 11, 13
 Defibrillator and Pacing: Test 8 - 13
 Catheterization and Pressure Transducer: Test 11 – 13
64

65. BLOOD CLOTS IN TEST 8 IN CHAMBERS
Figure 4.1.7 – Despite all washes performed, post-experiment
dissection showed heavy blood clots in cardiac chambers such as
near the chordae tendineae
65

66. TEST 11, N = 21
66

67. AORTIC PRESSURE FOR N = 22
Figure 4.1.13 – Aortic pressure mean data acquired for n = 22
67

68. TEST 11
Figure 4.1.15 – ventricular tachycardia for n = 21
68

69. TEST 11
Figure 4.1.17 – Mean aortic pressure for n = 21 69

70. TEST 13, N = 26 ECG
Figure 4.1.22 – (top) ventricular tachycardia leading to fibrillation
of n = 26. (Bottom) Stabilized heart rate n = 26 half an hour later
70

71. AORTIC PRESSURE
Figure 4.1.24 – aortic pressure for n = 25 stabilized at
t = 1 hour at 74.7 mmHg 71

72. RATE OF AORTIC PRESSURE FOR TEST 13
Figure 4.1.25 – pressure of continuous aortic pressure for n = 25, 26
0
20
40
60
80
100
120
140
3 7 17 19 66
Pressure(mmHg)
Time (Minutes)
Mean Aortic Pressure
n = 23
n = 24
72

73. TRANSMEDIC ORGAN CARE SYSTEM: HEART ™ [10]
Photo credit: http://www.transmedics.com/wt/page/organ_care
http://tesi.cab.unipd.it/36410/1/Tesi.pdf
Ex vivo resuscitation:
• build up its energy stores
• optimize its function
• perform full viability assessment
prior to transplantation
73