Funds at Work

Robert Poston, M.D.
University of Maryland

As the disparity in supply and demand for donor hearts for transplantation grows, there is a need for expanding the organ pool beyond the standard, or “ideal” donor such as the nonheartbeating donor (NHBD). The overriding concern for the use of hearts from these donors is the risk of graft primary nonfunction due to irreversible ischemic injury.

The ability to quantify ischemic injury in these hearts prior to transplant would represent a significant advance towards their application to cardiac transplantation. In our research, we confirmed that continuous perfusion of canine hearts exposed to global WI (i.e. model of the NHBD) is a reliable method for restoring systolic function of a majority of these organs. Moreover, a dynamic evaluation of the myocardial, endothelial and metabolic response of WI hearts to this perfusion interval provides an opportunity to predict the ultimate functional recovery prior to full, warm blood reperfusion. In the future, we hope to apply this technology to clinical heart transplantation in order to evaluate other so called “extended criteria” donors (e.g. hearts with low ejection fraction, elderly donors, long transport times) and to eventually adopt the NHBD for heart transplant.

Because of the TSFRE research committee’s focus on the proposal itself with less emphasis on preliminary data, this grant enabled me to initiate a novel research project that other grant sources would not have supported. I am very grateful to have been provided with this opportunity.