Moderate hypothermia duringex vivomachine perfusion promotes recovery of hearts donated after cardiocirculatory death
| Autor: | Veronika Olejnickova, Max Gassmann, Barbara Rosser, Anna Bogdanova, Herman Tolboom, Volkmar Falk, Diana Reser, Markus J. Wilhelm |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Myocardial Reperfusion In Vitro Techniques 030204 cardiovascular system & hematology 030230 surgery Contractility Random Allocation 03 medical and health sciences 0302 clinical medicine Reperfusion therapy Hypothermia Induced Internal medicine Heart rate medicine Animals Heart transplantation Machine perfusion biology business.industry Cold Ischemia Graft Survival Organ Preservation Recovery of Function General Medicine Tissue Donors Rats Death Survival Rate Disease Models Animal Rats Inbred Lew Tissue and Organ Harvesting biology.protein Cardiology Heart Transplantation Surgery Creatine kinase Cardiology and Cardiovascular Medicine business Perfusion Ex vivo |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 49:25-31 |
| ISSN: | 1873-734X 1010-7940 |
| DOI: | 10.1093/ejcts/ezv066 |
| Popis: | OBJECTIVES To establish the optimal machine perfusion temperature for recovery of hearts in a rodent model of donation after declaration of cardiocirculatory death (DCD). METHODS Hearts from male Lewis rats (n = 14/group) were subjected to 25 min of in situ warm (37°C) ischaemia to simulate DCD. They were then explanted and reperfused with diluted autologous blood for 60 min at 20, 25, 30, 33 or 37°C, after which they were stored at 0-4°C in Custodiol preservation solution for 240 min. Fresh-excised and cold-stored ischaemic hearts were used as controls. The viability of the different groups was assessed by comparing heart rate and left ventricular contractility in a Langendorff circuit, as well as perfusate levels of troponin-t and creatine kinase (CK), and myocardial levels of adenosine triphosphate (ATP) and reduced glutathione. RESULTS During ex vivo reperfusion, hearts in all groups resumed beating within minutes. The mean heart rate was highest in the 37°C group at 154.72 +/- 33.01 beats × min-1 (bpm), and declined in proportion to temperature to 39.72 +/- 5.53 bpm at 20°C. Troponin-t levels were highest in the 37°C group (79.49 +/- 20.79 µg/l), the values were significantly lower in all other reconditioned groups with a minimum of 12.472 +/- 7.08 µg/l in the 20°C group (P < 0.0001). Tissue ATP levels ranged from 4.32 ± 1.71 µmol/g at 33°C to 4.59 +/- 1.41 µmol/g at 30°C, all significantly higher than the mean ATP level of 1.41 +/- 0.93 µmol/g in untreated ischaemic hearts (P 0.0001). During Langendorff assessment, the mean heart rate and contractility of all groups were higher than those of cold-stored ischaemic hearts (P 0.0001), yet not significantly different from those of fresh controls. The perfusate levels of troponin-t and CK, and myocardial levels of reduced-glutathione and ATP were not significantly different between groups. CONCLUSION Our results suggest that mild hypothermia during ex vivo reperfusion improves recovery of ischaemic hearts in a rodent DCD model. |
| Databáze: | OpenAIRE |
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