Ex Situ Set-up and Protocol
The donor heart was then connected to the ESHP system cannulas that were
suspended in a 3D-printed custom-made holder. The circuit composed a
reservoir (Affinity Fusion®, Medtronic, Minneapolis, MN), an oxygenator
(Affinity Fusion®, Medtronic, Minneapolis, MN) and two centrifugal pumps
(560A and 540 T, Medtronic, Minneapolis, MN) working in parallel to
selectively load the LV and right ventricle (RV), as described above. A
heat exchanger (Sarns Dual Heater Cooler Model 11,160) maintained a
stabile temperature of 37°C.
The system was primed with 2000 mL of whole autologous blood from the
donor and normal saline to achieve a hematocrit > 25%.
Methylprednisolone (500 mg), heparin (10,000 IU), cefazolin (1 g) and
magnesium (2 g) were also added to the priming. Calcium chloride 10%,
sodium bicarbonate 8.4% and dextrose 50% were added to correct calcium
(1.1-1.3 mmol/L), glucose (5-10 mmol/L) and bicarbonate (24-30 mmol/L)
concentrations, respectively.