DE3712200A1 - Apparatus for the extracorporal long-term perfusion of human or animal tissue and for the extracorporal regeneration of organs - Google Patents

Apparatus for the extracorporal long-term perfusion of human or animal tissue and for the extracorporal regeneration of organs

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Publication number
DE3712200A1
DE3712200A1 DE19873712200 DE3712200A DE3712200A1 DE 3712200 A1 DE3712200 A1 DE 3712200A1 DE 19873712200 DE19873712200 DE 19873712200 DE 3712200 A DE3712200 A DE 3712200A DE 3712200 A1 DE3712200 A1 DE 3712200A1
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Germany
Prior art keywords
extracorporeal
organs
organ
extracorporal
biological tissue
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Application number
DE19873712200
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German (de)
Inventor
Joern Martens
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Individual
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Individual
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Priority to DE19873712200 priority Critical patent/DE3712200A1/en
Publication of DE3712200A1 publication Critical patent/DE3712200A1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
    • A01N1/00—Preservation of bodies of humans or animals, or parts thereof
    • A01N1/02—Preservation of living parts
    • A01N1/0236—Mechanical aspects
    • A01N1/0242—Apparatuses, i.e. devices used in the process of preservation of living parts, such as pumps, refrigeration devices or any other devices featuring moving parts and/or temperature controlling components
    • A01N1/0247—Apparatuses, i.e. devices used in the process of preservation of living parts, such as pumps, refrigeration devices or any other devices featuring moving parts and/or temperature controlling components for perfusion, i.e. for circulating fluid through organs, blood vessels or other living parts
    • A—HUMAN NECESSITIES
    • A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
    • A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
    • A01N1/00—Preservation of bodies of humans or animals, or parts thereof
    • A01N1/02—Preservation of living parts

Abstract

Apparatus for the extracorporal long-term perfusion of human or animal tissue and for the extracorporal regeneration of organs, preferably of hearts. It mainly comprises a blood pump (2) one of whose pump units (2b) supplies the general circulation (6) to which the biological tissue or organ (1) to be perfused, the artificial kidney (3) and the liver (5) are connected in parallel to one another, while the other pump unit (2a) supplies the lesser circulation (7) with oxygenator (4). The return from the pump unit (2b) which supplies the general circulation (6) is connected to the lesser circulation (7), so that both pump units (2a, 2b) of the blood pump (2) are indirectly arranged in series. The tissues or organs (1, 5) are located in a special organ carrier (9', 9''). Maintenance of the vital functions of the organs over a fairly long period of time is made possible and new perspectives are opened up in terms of therapeutic measures in the extracorporal blood circulation. "Extracorporal regeneration" of organs become possible. <IMAGE>

Description

Gegenstand der Erfindung ist eine Apparatur zur extrakorporalen Langzeit-Perfusion von biologi­ schem Gewebe und zur extrakorporalen Regeneration von Organen.The invention relates to an apparatus for extracorporeal long-term perfusion by biologi tissue and for extracorporeal regeneration of organs.

Die extrakorporale Perfusion von menschlichem oder tierischem Gewebe wird z. B. zur Erhaltung der Vi­ talfunktionen von Transplantaten angewandt. Zudem eröffnen sich neue Perspektiven in bezug auf the­ rapeutische Maßnahmen im extrakorporalen Blutkreis­ lauf. Die "extrakorporale Regeneration" von Orga­ nen wird möglich.The extracorporeal perfusion of human or animal tissue is e.g. B. to maintain the Vi Valley functions of transplants applied. In addition new perspectives with regard to the therapeutic measures in the extracorporeal bloodstream run. The "extracorporeal regeneration" from Orga NEN becomes possible.

Die Apparatur zur extrakorporalen Langzeit-Perfu­ sion gibt die Möglichkeit der medikamentösen Inten­ sivbehandlung des perfundierten Organs, da hierbei nicht der gesamte Metabolismus berücksichtigt wer­ den muß, sondern nur das Organ selbst, was Dosie­ rung und auch den Typ des Chemotherapeutikums anbe­ trifft. Der Einsatz und die Entwicklung völlig neu­ artiger organspezifischer Medikamente wird möglich, da auch Substanzen Anwendung finden können, die z. B. auf andere Organe stark toxisch wirken. Es kann auch die Komplikationsrate bei operativen Eingriffen gesenkt werden, das Organ ist chirurgisch und diag­ nostisch besser zugänglich und braucht nach dem Eingriff, der u. a. auch nicht unter Zeitdruck erfolgt, nicht sofort seine Funktion im Metabolismus zu über­ nehmen, sondern kann, unabhängig davon, graduell in seiner physiologischen Leistung gesteigert werden, was besonders nach Eingriffen am offenen Herzen von großer Bedeutung ist.The apparatus for extracorporeal long-term perfume sion gives the possibility of drug intensive active treatment of the perfused organ, since this not all metabolism is taken into account who it must, but only the organ itself, which Dosie and the type of chemotherapy drug meets. The use and development completely new like organ-specific medication becomes possible since substances can also be used, e.g. B. highly toxic to other organs. It can also the complication rate for surgical interventions be lowered, the organ is surgical and diag nostically more accessible and needs after Intervention which u. a. also not under time pressure, not immediately over its function in metabolism take, but can, regardless of it, gradually in its physiological performance can be increased which especially after open heart surgery from is of great importance.

Die extrakorporale Perfusion von Organen wurde auch schon in der Vergangenheit durchgeführt. Es ergaben sich jedoch Probleme in bezug auf die Hämodynamik und auf die Befestigung der Organe im extrakorpora­ len Kreislauf (s. u. a. Umberto Aglietti in Chirurgia Sperimentale, S. 219 und 325-326, Verlag E U S Roma/Italien).The extracorporeal perfusion of organs was also done already done in the past. It turned out However, there are problems related to hemodynamics  and on the attachment of the organs in the extracorpora len cycle (see, inter alia, Umberto Aglietti in Chirurgia Sperimentale, pp. 219 and 325-326, publisher E U S Roma / Italy).

Die erfindungsgemäße Konstruktion basiert hinsicht­ lich der Hämodynamik auf einer Blutpumpe (2), (siehe Deutsches Patent P 36 02 727.8), die bei ausgezeichne­ ten inneren Strömungsverhältnissen und, u. a. "Star­ ling Effekt", Volumenausgleich von kleinem und gro­ ßem Kreislauf, Anrep-Effekt und als wesentliche Verbesserung eine sogenannte "Windkessel-Funktion" aufweist, d. h., sowohl systolischer Blutdruck als auch der folgende diastolische Druckabfall sind eine direkte Folge der Volumenarbeit der Blutpumpe, auch der arterio-venöse Blutdruck-Gradient ist, inner­ halb gewisser Grenzen, vorbestimmbar. So ergeben sich sehr gute hämodynamische Verhältnisse für eine kom­ plikationslose Perfusion von Organen.With regard to hemodynamics, the construction according to the invention is based on a blood pump ( 2 ) (see German Patent P 36 02 727.8) which, in the case of excellent internal flow conditions and, inter alia, “starling effect”, volume compensation of small and large circuits, response Effect and as a significant improvement has a so-called "wind boiler function", that is, both systolic blood pressure and the subsequent diastolic pressure drop are a direct result of the volume work of the blood pump, and the arteriovenous blood pressure gradient is within certain limits, can be predetermined . This results in very good hemodynamic conditions for uncomplicated organ perfusion.

Der spezielle erfindungsgemäße Organträger (9′, 9′′) sieht auch eine physiologische externe Druckänderung für das Organ vor. Dies wird z. B. mittels Membranpumpen (10 a, 10 b) erreicht, die das Druckmittel im Behälter (8′, 8′′), vorzugsweise physiologische Kochsalzlösung, kom­ primieren und expandieren und so auch das darin be­ festigte Säckchen komprimieren bzw. expandieren. Da das Organ (5, 1) nach Anschluß der Blutgefäße an den extrakorporalen großen Kreislauf (6) und z. B. im Falle der Niere, der ableitenden Harnwege an eine Ent­ sorgungsleitung angeschlossen und im druckdicht ver­ schlossenen Säckchen mit einem porenlosen biologisch verträglichen Schaum (PU), dessen spezifisches Gewicht ungefähr dem des Organs (1, 5) entspricht, umschäumt wird. Das Organ ist so gleichmäßig im Behälter (8′, 8′′) fixiert, Dekubitusprobleme werden dadurch vermieden, daß die Behälter (2) mit den Organen (1, 5) langsam um eine Achse (11) wechselseitig gedreht werden (z. B. 360°/min.). Im Oxygenerator (4) findet nicht nur der Gasaustausch O2 - CO2 statt, sondern es wird dort auch die Tem­ peratur des Blutes reguliert. Als Leber (5) findet z. B. eine Tierleber (Schweineleber) Verwendung. Als "künstliche Niere" (3) ein Dialysator.The special organ support according to the invention ( 9 ', 9'' ) also provides a physiological external pressure change for the organ. This is e.g. B. achieved by means of diaphragm pumps ( 10 a , 10 b) which compress and expand the pressure medium in the container ( 8 ', 8'' ), preferably physiological saline, com and thus compress or expand the bag which is fastened therein. Since the organ ( 5, 1 ) after connecting the blood vessels to the extracorporeal large circuit ( 6 ) and z. B. in the case of the kidney, the urinary tract connected to a supply line Ent and in the pressure-tight sealed bag with a non-porous biologically compatible foam (PU) , the specific weight of which corresponds approximately to that of the organ ( 1, 5 ), is foamed. The organ is so evenly fixed in the container ( 8 ', 8'' ), pressure ulcer problems are avoided by slowly rotating the container ( 2 ) with the organs ( 1, 5 ) around an axis ( 11 ) (e.g. . 360 ° / min.). In the oxygenator ( 4 ) not only the gas exchange O 2 - CO 2 takes place, but also the temperature of the blood is regulated there. As a liver ( 5 ) takes place, for. B. an animal liver (pork liver) use. A dialyzer as an "artificial kidney" ( 3 ).

Claims (4)

1. Apparatur zur extrakorporalen Langzeit-Perfusion von biologischem Gewebe und zur extrakorporalen Re­ generation von Organen, dadurch gekennzeichnet, daß das biologische Gewebe oder Organ (1) in einem extrakorporalen Blutkreislauf angeordnet ist, der vorzugsweise aus einer Blutpumpe (2), einer künst­ lichen Niere (3), einem Oxygenerator (4) und einer perfundierten Leber (5) und deren Verbindungslei­ tungen besteht.1. apparatus for extracorporeal long-term perfusion of biological tissue and for extracorporeal re generation of organs, characterized in that the biological tissue or organ ( 1 ) is arranged in an extracorporeal blood circuit, which is preferably from a blood pump ( 2 ), an artificial union Kidney ( 3 ), an oxygenator ( 4 ) and a perfused liver ( 5 ) and their connecting lines. 2. Apparatur zur extrakorporalen Langzeit-Perfusion von biologischem Gewebe und zur extrakorporalen Re­ generation von Organen nach Anspruch 1, dadurch gekennzeichnet, daß die Blutpumpe (2) zwei getrenn­ te Pumpeinheiten als künstliche Herzkammern (2 a) (2 b) aufweist, wobei die eine Pumpeinheit (2 b) den großen Kreislauf (6) versorgt, an dem das zu perfundieren­ de biologische Gewebe (1), die künstliche Niere (3) und die Leber (5) parallel zueinander angeschlossen sind, und die andere Pumpeinheit (2 a) den kleinen Kreislauf (7) versorgt, an den der Oxygenerator (4) angeschlossen wird, wobei der Rücklauf der Pumpen­ einheit (2 b), die den großen Kreislauf (6) versorgt, mit dem kleinen Kreislauf (7) verbunden ist, und damit beide Pumpeinheiten (2 a, 2 b) der Blutpumpe (2) indirekt in Reihe angeordnet sind.2. Apparatus for extracorporeal long-term perfusion of biological tissue and for extracorporeal re generation of organs according to claim 1, characterized in that the blood pump ( 2 ) has two separate te pumping units as artificial heart chambers ( 2 a ) ( 2 b) , the a pump unit ( 2 b) supplies the large circuit ( 6 ) to which the biological tissue ( 1 ) to be perfused, the artificial kidney ( 3 ) and the liver ( 5 ) are connected in parallel, and the other pump unit ( 2 a ) supplies the small circuit ( 7 ) to which the oxygen generator ( 4 ) is connected, the return of the pump unit ( 2 b) , which supplies the large circuit ( 6 ), is connected to the small circuit ( 7 ), and so that both pump units ( 2 a , 2 b) of the blood pump ( 2 ) are arranged indirectly in series. 3. Apparatur zur extrakorporalen Langzeit-Perfusion von biologischem Gewebe und zur extrakorporalen Rege­ neration von Organen nach Anspruch 1 und 2, dadurch gekennzeichnet, daß sich die Organe (z. B. 5, 1) in einem speziellen Organträger (9′, 9′′) befinden, der aus einem Säckchen, das formschlüssig und gleich­ mäßig mit der gesamten Organoberfläche indirekt verbunden ist, und einem formfesten Behälter (8′, 8′′) besteht, der druckdichte Durchführungen für die An­ schlüsse der Organ-Gefäße aufweist und einen An­ schluß für das Druckmittel besitzt, das das Säck­ chen, welches im Behälter (8′, 8′′) druckdicht ange­ ordnet ist, entsprechend den physiologischen Druck­ verhältnissen des Organs im Körper beaufschlagt.3. Apparatus for extracorporeal long-term perfusion of biological tissue and for extracorporeal regeneration of organs according to claim 1 and 2, characterized in that the organs (z. B. 5, 1 ) in a special organ support ( 9 ', 9'' ) Are located, which consists of a bag that is positively and evenly indirectly connected to the entire organ surface, and a rigid container ( 8', 8 '' ), which has pressure-tight bushings for the connections to the organ vessels and one At the end of the pressure medium possesses the bag, which is arranged in a pressure-tight manner in the container ( 8 ', 8'' ), acted upon according to the physiological pressure conditions of the organ in the body. 4. Apparatur zur extrakorporalen Langzeit-Perfusion von biologischem Gewebe und zur extrakorporalen Regeneration von Organen nach Anspruch 1-3, dadurch gekennzeichnet, daß der extrakorporale Blutkreis­ lauf vorzugsweise mit dem Blut des Organspenders beschickt wird.4. Apparatus for extracorporeal long-term perfusion from biological tissue to extracorporeal Regeneration of organs according to claims 1-3, characterized characterized that the extracorporeal bloodstream preferably run with the blood from the organ donor is loaded.
DE19873712200 1987-04-10 1987-04-10 Apparatus for the extracorporal long-term perfusion of human or animal tissue and for the extracorporal regeneration of organs Withdrawn DE3712200A1 (en)

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DE19873712200 DE3712200A1 (en) 1987-04-10 1987-04-10 Apparatus for the extracorporal long-term perfusion of human or animal tissue and for the extracorporal regeneration of organs

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3825086A1 (en) * 1988-07-23 1990-01-25 Joern Martens Fully implantable blood pump
DE4201259A1 (en) * 1992-01-18 1993-07-22 Sachs Elektronik Kg Hugo Isolated heart perfusion appts. - has closed vessel with fluid and adjustable gas vol. to give timed aorta pressure
WO1994028710A1 (en) * 1993-06-07 1994-12-22 Berndt Mayer Method and device for conserving organs, body extremities and pieces of body tissue
WO2000055299A1 (en) * 1999-03-15 2000-09-21 Wolfgang Fege Device for culturing human or animal tissue
US7811808B2 (en) 2003-07-30 2010-10-12 Organ Assist B.V. Portable preservation apparatus for a donor organ

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3825086A1 (en) * 1988-07-23 1990-01-25 Joern Martens Fully implantable blood pump
DE3825086C2 (en) * 1988-07-23 1998-04-09 Joern Martens Fully implantable blood pump
DE4201259A1 (en) * 1992-01-18 1993-07-22 Sachs Elektronik Kg Hugo Isolated heart perfusion appts. - has closed vessel with fluid and adjustable gas vol. to give timed aorta pressure
WO1994028710A1 (en) * 1993-06-07 1994-12-22 Berndt Mayer Method and device for conserving organs, body extremities and pieces of body tissue
WO2000055299A1 (en) * 1999-03-15 2000-09-21 Wolfgang Fege Device for culturing human or animal tissue
US7811808B2 (en) 2003-07-30 2010-10-12 Organ Assist B.V. Portable preservation apparatus for a donor organ

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