A novel compartmentalised stent graft to isolate the perfusion of the abdominal organs

Abstract

Donation after cardiac death has been adopted to address the critical shortage of donor organs for transplant. Recovery of these organs is hindered by low blood flow that leads to permanent organ injury. We propose a novel approach to isolate the perfusion of the abdominal organs from the systemic malperfusion of the dying donor. We reasoned that this design could improve blood flow to organs without open surgery, while respecting the ethical principle that cardiac stress not be increased during organ recovery. Conditions within the stent were analysed using a computational fluid dynamics (CFD) method and validated on two prototypes in vitro. The hydrodynamic pressure drop across the stent was measured as 0.14–0.22 mmHg, which is a negligible influence. Device placement studies were also conducted on swine model fluoroscopically. All these results demonstrated the feasibility of rapidly isolating the perfusion to abdominal organs using a compartmentalised stent graft design.

Keywords:

• Organ donor
• transplant
• stent
• computational fluid dynamics
• ischaemia

Disclosure statement

The authors have no conflicts of interest to report. The authors alone are responsible for the writing and contents of the paper.

Funding

The authors would like to acknowledge financial support from the Organ Donation Research Consortium, the Commonwealth of Pennsylvania, the University of Pittsburgh Medical Centre (UPMC) Department of Surgery and UPMC Division of Vascular Surgery.