|
1
|
Medina CK, Aykut B, Kang L, McVadon D, Overbey DM, Helke KL, Taylor CL, Fitzgerald DC, Hassid M, Braxton AM, Miller SG, Mealer C, Ho CS, Whitworth KM, Prather RS, Moya-Mendez ME, Jeffs S, Parker LE, Turek JW, Rajab TK. Surgical Protocol for Partial Heart Transplantation in Growing Piglets. World J Pediatr Congenit Heart Surg 2024:21501351241245115. [PMID: 38780414 DOI: 10.1177/21501351241245115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Partial heart transplantation is a new approach to deliver growing heart valve implants. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary heart valve is transplanted. This allows partial heart transplants to grow, similar to the valves in heart transplants. However, the transplant biology of partial heart transplantation remains unexplored. This is a critical barrier to progress of the field. Without knowledge about the specific transplant biology of partial heart transplantation, children with partial heart transplants are empirically treated like children with heart transplants because the valves in heart transplants are known to grow. In order to progress the field, an animal model for partial heart transplantation is necessary. Here, we contribute our surgical protocol for partial heart transplantation in growing piglets. All aspects of partial heart transplantation, including the donor procedure, the recipient procedure, and recipient perioperative care are described in detail. There are important nuances in the conduct of virtually all aspects of open heart surgery that differs in piglets from humans. Our surgical protocol, which is based on our experience with 34 piglets, will allow other investigators to leverage our experience to seek fundamental knowledge about the nature of partial heart transplants. This is significant because the partial heart transplant model in piglets is complex and very resource intensive.
Collapse
Affiliation(s)
- Cathlyn K Medina
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Berk Aykut
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Lillian Kang
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Deani McVadon
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Douglas M Overbey
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Kristi L Helke
- Department of Comparative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Carolyn L Taylor
- Department of Comparative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - David C Fitzgerald
- Division of Cardiovascular Perfusion, Department of Clinical Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Marc Hassid
- Division of Pediatric Cardiac Anesthesia, Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Alicia M Braxton
- Department of Comparative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Stephen G Miller
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
| | - Corey Mealer
- Department of Comparative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Chak-Sum Ho
- Gift of Hope Organ and Tissue Donor Network, Chicago, IL, USA
| | - Kristin M Whitworth
- National Swine Resource and Research Center, University of Missouri, MO, USA
| | - Randall S Prather
- National Swine Resource and Research Center, University of Missouri, MO, USA
| | | | - Sydney Jeffs
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Lauren E Parker
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Joseph W Turek
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | | |
Collapse
|
|
2
|
Rajab TK. Partial heart transplantation: Growing heart valve implants for children. Artif Organs 2024; 48:326-335. [PMID: 37849378 PMCID: PMC10960715 DOI: 10.1111/aor.14664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023]
Abstract
Heart valves serve a vital hemodynamic function to ensure unidirectional blood flow. Additionally, native heart valves serve biological functions such as growth and self-repair. Heart valve implants mimic the hemodynamic function of native heart valves, but are unable to fulfill their biological functions. We developed partial heart transplantation to deliver heart valve implants that fulfill all functions of native heart valves. This is particularly advantageous for children, who require growing heart valve implants. This invited review outlines the past, present and future of partial heart transplantation.
Collapse
Affiliation(s)
- Taufiek Konrad Rajab
- Division of Pediatric Cardiovascular Surgery, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| |
Collapse
|