Ischemia-reperfusion injuryExperimental: ThoracicImportance of Organ Preservation Solution Composition in Reducing Myocardial Edema during Machine Perfusion for Heart Transplantation
Section snippets
Experimental Protocol
The protocol for this study was approved by the Institutional Animal Care and Use Committee at the University of Texas Southwestern Medical Center. All animals were treated within guidelines set forth in the Guide for the Care and use of Laboratory Animals (National Institutes of Health Publication no. 86-23, revised 1996). Adult mongrel dogs were used in this experiment. In each experiment, hearts were removed from anesthetized dogs and established in a perfusion device that provided
Myocardial Edema
Tissue weight change over the preservation interval differed significantly between the Celsior and UWMPS groups. After 10 hours of perfusion, heart weight in the Celsior group increased by 31.3 ± 4.3%, whereas heart weight in the UWMPS group decreased by 3.3 ± 1.9% (P < .001). Similarly, LV water content at the end of the preservation interval was significantly higher in the Celsior group (80.2 ± 1.3%) than in the UWMPS group (75.9 ± 0.3%; P < .005; Fig 1, Fig 2).
Oxygen Consumption and Myocardial Metabolism
Despite increased edema
Discussion
Current heart preservation strategies involving cardioplegic arrest and cold immersion in the preservation solution have not changed substantially since long-distance transplantation procedures originated. Machine perfusion has moved into the clinical arena for other organs and has proven to be clinically superior to hypothermic static storage of renal allografts.12 Experimental data suggest that for heart preservation, machine perfusion provides homogenous myocardial nutrient delivery,
References (15)
- et al.
Machine perfusion preservation improves renal allograft survival
Am J Transplant
(2007) - et al.
Perfusion preservation maintains myocardial ATP levels and reduces apoptosis in an ex vivo rat heart transplantation model
Surgery
(2005) - et al.
Perfusion Preservation versus Static Preservation for Cardiac Transplantation: Effects on Myocardial Function and Metabolism
J Heart Lung Transplant
(2008) - et al.
Arresting donor hearts with extracellular-type cardioplegia prevents vasoconstriction induced by UW solution
Cardiovasc Surg
(1998) - et al.
A multicenter, randomized, controlled trial of Celsior for flush and hypothermic storage of cardiac allografts
Ann Thorac Surg
(2001) - et al.
A comparative study of the most widely used solutions for cardiac graft preservation during hypothermia
J Heart Lung Transplant
(2002) - et al.
Myocardial perfusion characteristics during machine perfusion for heart transplantation
Surgery
(2008)
Cited by (19)
Machine perfusion of circulatory determined death hearts: A scoping review
2020, Transplantation ReviewsCitation Excerpt :For a well-controlled pH, sodiumbicarbonate was used most commonly [13,23,27,28], next to n-2-hydroxyethylpiperazine-n’-2-ethanesulfonic acid (HEPES) [11,21,29] and Tris buffer [27,28]. In one case, histidine, an aminoacidic buffer from erythrocytes, was used in concentration of 30 g/L [30,35]. Besides, many other pharmacological agents were comprised in the crystalloid solutions.
Myocardial protection by propolis during prolonged hypothermic preservation
2019, CryobiologyCitation Excerpt :Under these conditions, propolis had a benefical role since it reduced significantly the rate of H2O2 production to 0.450 ± 0.008 and 0.412 ± 0.040 nmol H2O2/min/mg protein at the respective propolis concentrations of 150 μg/ml and 250 μg/ml. During transplantation, the recovery of heart functions after an ischemic period depends on preservation conditions that include necessary components to maintain cell viability and hypothermia to prolong the period of preservation [14]. Consequently, any intervention aiming to reduce damages during ischemic phase will attenuate the severity of the reperfusion injury.
Outcomes of Donation After Circulatory Death Heart Transplantation in Australia
2019, Journal of the American College of CardiologySteroids Limit Myocardial Edema During Ex Vivo Perfusion of Hearts Donated After Circulatory Death
2018, Annals of Thoracic SurgeryA whole blood-based perfusate provides superior preservation of myocardial function during ex vivo heart perfusion
2015, Journal of Heart and Lung TransplantationEffects of antegrade and retrograde machine perfusion preservation on cardiac function after transplantation in canines
2014, Transplantation ProceedingsCitation Excerpt :One possibility may be related to the degree of myocardial edema that can develop in perfused hearts. We previously reported that antegrade perfused hearts can develop significant myocardial edema when perfused with Celsior over extended storage intervals [20]. Edema seems to develop much sooner in retrograde perfused hearts, likely due to the increased flow rates required to achieve adequate tissue nutrient flow, and unlike in antegrade perfused hearts, this effect seems to be relatively independent of the preservation solution [17].