Student Scholarship Essay Contest Page 1

The Future of Perfusion

By Andrea Berra

  Perfusion research reveals increasing ways in which perfusionists can provide patients with the best care possible. Life expectancy for the U.S. national population has increased to a record high of 77.8 years1. With this increase in life expectancy, the number one leading cause of death for people over the age of 65 is still heart disease2. By the year 2030, it is expected that one in five Americans will be a senior citizen3. With this increase in population age and unfortunate disease, the demand for cardiac and perfusion procedures will also increase.  

The future of perfusion relies heavily on research, which has initiated further important advancements in perfusion. Research evidence based medicine helps develop "best practices" in reducing morbidity and mortality rate. Equipment biocompatibility, mechanical circulatory assist devices, and organ preservation represent a few of the areas that are currently being researched and represent the future of advanced perfusion.

Equipment Biocompatibility:  With an increase in research and trials, new types of extracorporeal circuits (ECC) (such as mini and coated circuits) and additional laboratory equipment have been developed. Additional research in decreased blood to surface contact, priming volume, hemodilution, hemolysis of red blood cells, allogeneic blood usage, and an overall decrease in inflammatory response will help pave the way for new possibilities in perfusion. These and many more factors will ultimately lead to a decrease in intraoperative and postoperative risk of patients being on cardiopulmonary bypass (CPB).

Mechanical Circulatory Assist Devices:  The bridge to recovery, bridge to transplant, and destination therapy provide patients with successful recovery from cardiac surgeries and an increase in life span. Circulatory assist devices such as these help support the heart and allow the heart to recover. In the future, as perfusionists become experts in the operation of these devices, they anticipate observing decreased bleeding, thromboembolism, and infection rate. At the same time, more efficient power sources (battery charged) will increase the reliability of the devices. Ultimately, with improved patient outcome and regular use, a decrease in cost may be more feasible. The continued demand and improvement of theses devices shows promise in the perfusion field.

Organ Preservation:  Advanced training and equipment have brought organ transplantation to a new frontier. Organ transplantation has advanced due to organ preservation performed by the perfusionist. Improved perfusate and preservation techniques need further research to improve the amount of time the organs may have between the recipient and donor as well as a better response to the recipient's body. The role of organ preservation by perfusionists continues to strengthen as more hospitals perform transplants. The above examples partially represent the future of perfusion. Other areas such as monitoring techniques, autotransfusion for various surgeries, platelet gel, artificial hearts, artificial blood, robotic cardiac surgery, and intra-thoracic and intra-abdominal chemotherapy all indicate even further promise in the advancement of perfusion. In addition, an increase in perfusion training and education will dramatically increase the knowledge of future perfusionists and expand the availability of perfusion research.