Cardioprotection in heart transplantation and cardiac machine perfusion

The Longnus Lab is focussed on investigating the pathophysiology of acute cardiac ischemia-reperfusion injury, cardioprotection and biomarkers in the context of heart transplantation, especially donation after circulatory death (DCD) and cardiac machine perfusion. The key research interests of the lab are as follows:

Influence of pre-ischemic conditions on post-ischemic recovery

Conditions surrounding donor death and circulatory arrest can affect the quality of cardiac DCD grafts. We are specifically interested in how systemic and metabolic changes in the donor influence cardiac graft quality.
Tolerance of cardiac DCD grafts to warm ischemia and reperfusion
Prolonged ischemia leads to cardiac damage, but the heart is able to withstand a limited period of ischemia. Our team is interested in metabolic, mitochondrial and vascular mechanisms of injury of cardiac grafts, especially those obtained with DCD.

Evaluation of cardiac grafts during machine perfusion

As DCD cardiac grafts are subjected to damaging conditions in the donor, including a period of warm ischemia, it is critical to safely determine the cardiac damage / function after ischemia in order to predict graft suitability for transplantation and post-transplant function. Furthermore, improved cardiac evaluation measures may enable the application of targeted therapies for either the graft (during machine perfusion), or the recipient. We aim to establish robust and reliable, clinically applicable means to evaluate graft quality and predict graft recovery of cardiac grafts, particularly in the context of DCD. 

Cardioprotection

As machine perfusion of a cardiac graft following procurement is a modifiable, scheduled intervention, it provides an opportunity to tailor reperfusion conditions to promote optimal graft recovery. Our aim is to identify and develop cardioprotective strategies to improve the post-ischemic recovery of DCD grafts.

Precision approaches with cardiac machine perfusion

Another research focus concerns precision therapies that can be applied with the use of cardiac machine perfusion techniques for heart transplantation and beyond. For example, in DCD heart transplantation, machine perfusion conditions and therapies may be tailored to donor age and/ or sex to achieve optimal graft quality. Importantly, cardiac machine perfusion may be used for precision therapies outside the area of heart transplantation, such as for the development and application of novel approaches with autotransplantation.