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Moderate hypothermia duringex vivomachine perfusion promotes recovery of hearts donated after cardiocirculatory death
- Source :
- European Journal of Cardio-Thoracic Surgery. 49:25-31
- Publication Year :
- 2015
- Publisher :
- Oxford University Press (OUP), 2015.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 1873734X and 10107940
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....8e3dbf55403d2396a066f787f6dc0755