Comparison of different porcine models simulating myocardial cold ischemia of pediatric donor hearts.

Autor:	Stukov Y; Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, USA.; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA., Bleiweis MS; Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, USA.; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA., Wilson L; Congenital Heart Center, Division of Pediatric Cardiology, Department of Pediatrics, University of Florida, Gainesville, Florida, USA., Peek GJ; Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, USA.; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA., March K; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.; Malcom Randall VA Medical Center, Gainesville, Florida, USA., Richards EM; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.; Department of Physiology and Aging, University of Florida, Gainesville, Florida, USA., Staples ED; Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, USA.; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.; Malcom Randall VA Medical Center, Gainesville, Florida, USA., Jacobs JP; Congenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, Florida, USA.; UF Center for Regenerative Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
Jazyk:	angličtina
Zdroj:	Perfusion [Perfusion] 2024 Feb 23, pp. 2676591241226464. Date of Electronic Publication: 2024 Feb 23.
DOI:	10.1177/02676591241226464
Abstrakt:	Background: Our team previously identified a stem cell-derived cardioprotective additive that can be added to standard cardioplegia to extend myocardial viability during prolonged myocardial cold ischemic time (CIT) in rodent models. The purpose of this study was to utilize a porcine model to compare in-vivo versus ex-vivo porcine simulation of CIT that accompanies cardiac transplantation in humans, in order to determine an optimal method for translation of our studies to larger animals. Methods: Eight 39-55 kg Yorkshire X pigs were randomly assigned to either in-vivo or ex-vivo simulation. After administration of general anesthesia and endotracheal intubation, baseline measurement of left ventricular performance was obtained via transesophageal echocardiography (TEE). After midline sternotomy and heparin administration, the aorta was cross-clamped and two liters of HTK-Custodiol were introduced via the aortic root. The in-vivo method utilized cold ischemic heart storage in the chest cavity while supporting the experimental animal with cardiopulmonary bypass (CPB). The ex-vivo method involved standard cardiac procurement, cold ischemic storage outside of the body, and subsequent cardiac reperfusion utilizing cardiac reanimation in a Langendorff heart perfusion mode. After CIT, measurements of post-ischemic left ventricular performance were obtained via echocardiography. Results are presented as: Mean ± Standard Deviation (Median, Minimum-Maximum). Results: Weight (kilograms) was similar in the in-vivo group and the ex-vivo group: 44 ± 1.8 (44, 42-46) versus 44 ± 5.1 (43.5, 39-51), respectively. Cold ischemic time (minutes) was longer in the ex-vivo group: 360 ± 0 (360, 360-360) versus 141 ± 26.7 (149, 102-163). Temperature (degrees Celsius) was colder in the ex-vivo group: 8 ± 0 (8, 8-8) versus 16.5 ± 4.2 (16, 12-16).In the in-vivo group, baseline ejection fraction and ejection fraction after CIT were: 48.25% ± 14.95% (48.5%, 33%-63%) and 41.25% ± 22.32% (41.5%, 20%-62%), respectively. In the ex-vivo group, baseline ejection fraction and ejection fraction after CIT were: 56.4% ± 5.9% (57%, 50%-67%) and 60.4% ± 7.7% (61.5%, 51.9%-67%), respectively. Conclusion: The ex-vivo technique is suitable to evaluate cardioplegia additives that may substantially extend myocardial tolerance to cold ischemia.
Databáze:	MEDLINE
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