Perioperative Telemetric Monitoring in Pig-to-Baboon Heterotopic Thoracic Cardiac Xenotransplantation
Matthias Längin, Alessandro Panelli, Bruno Reichart, Alexander Kind, Paolo Brenner, Tanja Mayr, Jan-Michael Abicht
(Department of Anaesthesiology, University Hospital, Ludwig Maximilian University (LMU), Munich, Germany)
Ann Transplant 2018; 23:491-499
Perioperative monitoring and hemodynamic management after heterotopic thoracic cardiac xenotransplantation is challenging due to 2 independently beating hearts. Telemetry allows continuous monitoring of hemodynamic parameters of both the donor and recipient hearts. We describe our experience and report on the validity of a telemetric system during and after surgery.
MATERIAL AND METHODS: Wireless telemetry transmitters were implanted in 3 baboons receiving porcine donor hearts. Left ventricular pressure and ECG were assessed from the donor heart, whereas aortic pressure and temperature were assessed from the recipient. Telemetric data were validated with invasive blood pressure measurements.
RESULTS: Telemetric blood pressure was lower than invasive blood pressure. Intraoperatively, the probe in the graft’s left ventricle measured negative end-diastolic pressures. Telemetry allowed simple discrimination between donor’s and recipient’s heart rates. Body temperature was underestimated by telemetry. Telemetric monitoring facilitates recognition of graft arrhythmias and volume demand.
CONCLUSIONS: In heterotopic thoracic cardiac xenotransplantation, telemetric implants are useful tools to continuously monitor the animals’ hemodynamic parameters and to discriminate donor and recipient organs. Accuracy is sufficient for systemic pressure measurement, but perioperative use of left ventricular end-diastolic pressure as a surrogate parameter for graft function is not advisable. Temperature measurements by telemetry do not reflect body core temperature.
Keywords: monitoring, Heart Transplantation, Telemetry, Transplantation, Heterologous