Anna Corderfeldt Keiller: Reactions as blood is circulated and oxygenated by machines

Figure 6, page 37 of the thesis. Schematic illustration of heart-lung machine connected to blood vessels in leg for regional chemotherapy treatment with isolated limb perfusion. Image by Roger Olofsson Bagge.

Anna Corderfeldt Keiller: Reactions as blood is circulated and oxygenated by machines

Published

9 May 2024

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The role of heart-lung machines in healthcare has expanded to include cancer treatment. Anna Corderfeldt Keiller’s doctoral thesis sheds light on the physiological reactions when blood is circulated and oxygenated artificially, potentially improving treatment outcomes while reducing side effects.

Anna Corderfeldt Keiller, a perfusionist at Thoracic surgery, Sahlgrenska University Hospital, and doctoral student at the Institute of Clinical 91̽��s.

ANNA CORDERFELDT KEILLER
Dissertation defense: 31 May 2024 (click for details)
Doctoral thesis:
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical 91̽��s

Heart-lung machines entered healthcare in the 1950s, enabling advanced heart surgeries. Over time, various types of circulation pumps have evolved for different purposes, expanding treatment options.

One such example is isolated limb perfusion, a regional cancer therapy primarily utilized in the treatment of malignant melanoma and sarcoma. Through surgery, cancer-affected extremities – arms or legs – are connected to a heart-lung machine. Then, the isolated body part is circulated with an extremely high dose of chemotherapy without affecting the rest of the body.

Anna Corderfeldt Keiller, a perfusionist at Thoracic surgery, Sahlgrenska University Hospital, oversees extracorporeal circulation (ECC), where blood leaves the body via tubes and undergoes artificial circulation and oxygenation.

Figure 7, page 38 of the thesis. Metastasized left leg, cannulated and isolated from the systemic circulation, is circulated with high doses of chemotherapy by a heart-lung machine. Photo: Roger Olofsson Bagge, published with the patient's consent.

Mapping oxygen demand

What is your research about?
“Systematically mapping tissue oxygen demand in an isolated extremity during isolated limb perfusion has enhanced our ability to optimize perfusion during the procedure. This knowledge has the potential to improve treatment outcomes and reduce treatment side effects,” says Anna Corderfeldt Keiller.

“Additionally, we’ve measured peripheral nerve damage markers during isolated limb perfusion and brain injury markers at varying pump flows from the heart-lung machine during heart surgery. This has enhanced our understanding of how treatment methods affect our patients.”

Cover illustration of the thesis. AI-generated picture of a fictive mechanical heart with inspiration from the style of Leonardo da Vinci.

Interaction of various factors

What has been enjoyable and rewarding about your doctoral project?
“The most rewarding part has been delving into specific aspects of patient physiology previously unknown during procedures involving extracorporeal circulation.”

And what challenges have you faced?
“The most challenging part has been understanding how different factors – such as the surgical procedure, the disease itself, and extracorporeal circulation – affect patient physiology when interacting with each other.”

Text: Jakob Lundberg

Area

Health and medicine