Clamping of the Aortic Arch Vessels During Normothermic Regional Perfusion Does Not Negatively Affect Donor Cardiac Function in Donation After Circulatory Death.

Autor:	Moeslund N; Department of Cardiology, Aarhus University Hospital, Denmark.; Department for Clinical Medicine-Comparative Medicine Laboratory, Aarhus University, Denmark., Zhang ZL; Department for Cardiothoracic Surgery, University Medical Centre Groningen, The Netherlands., Dalsgaard FF; Department of Cardiology, Aarhus University Hospital, Denmark.; Department for Clinical Medicine-Comparative Medicine Laboratory, Aarhus University, Denmark., Glenting SB; Department for Clinical Medicine-Comparative Medicine Laboratory, Aarhus University, Denmark., Ilkjaer LB; Department for Cardiothoracic Surgery, Aarhus University Hospital, Denmark., Ryhammer P; Department for Anesthesiology, Region Hospital Silkeborg, Denmark., Palmfeldt J; Research Unit for Molecular Medicine, Institute for Clinical Medicine, Aarhus University, Denmark., Pedersen M; Department for Clinical Medicine-Comparative Medicine Laboratory, Aarhus University, Denmark., Erasmus M; Department for Cardiothoracic Surgery, University Medical Centre Groningen, The Netherlands., Eiskjaer H; Department of Cardiology, Aarhus University Hospital, Denmark.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Jan 01; Vol. 107 (1), pp. e3-e10. Date of Electronic Publication: 2022 Aug 31.
DOI:	10.1097/TP.0000000000004298
Abstrakt:	Background: The hemodynamic effects of aortic arch vessel (AAV) clamping during normothermic regional perfusion (NRP) in donation after circulatory death is unknown. We investigated effects of AAV clamping during NRP compared with no clamping in a porcine model. Methods: In 16 pigs, hemodynamic parameters were recorded including biventricular pressure-volume measurements and invasive blood pressure. Additionally, blood gas parameters and inflammatory cytokines were used to assess the effect of AAV clamping. The animals were centrally cannulated for NRP, and baseline measurements were obtained before hypoxic circulatory arrest was induced by halting mechanical ventilation. During an 8-min asystole period, the animals were randomized to clamp (n = 8) or no-clamp (n = 8) of the AAV before commencement of NRP. During NRP, circulation was supported with norepinephrine (NE) and dobutamine. After 30 min of NRP, animals were weaned and observed for 180 min post-NRP. Results: All hearts were successfully reanimated and weaned from NRP. The nonclamp groups received significantly more NE to maintain a mean arterial pressure >60 mm Hg during and after NRP compared with the clamp group. There were no between group differences in blood pressure or cardiac output. Pressure-volume measurements demonstrated preserved cardiac function' including ejection fraction and diastolic and systolic function. No between group differences in inflammatory markers were observed. Conclusions: AAV clamping did not negatively affect donor cardiac function or inflammation after circulatory death and NRP. Significantly less NE was used to support in the clamp group than in the nonclamp group. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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