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Temperature-Related Effects of Myocardial Protection Strategies in Swine Hearts after Prolonged Warm Ischemia

Authors :
Anna Maria Tolomeo
Assunta Fabozzo
Ricardo Malvicini
Giada De Lazzari
Paola Bisaccia
Gianluca Gaburro
Diletta Arcidiacono
Denni Notarangelo
Federico Caicci
Fabio Zanella
Massimo Marchesan
Gustavo Yannarelli
Gianfranco Santovito
Maurizio Muraca
Gino Gerosa
Source :
Antioxidants, Vol 11, Iss 3, p 476 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Insufficient supply of cardiac grafts represents a severe obstacle in heart transplantation. Donation after circulatory death (DCD), in addition to conventional donation after brain death, is one promising option to overcome the organ shortage. However, DCD organs undergo an inevitably longer period of unprotected warm ischemia between circulatory arrest and graft procurement. In this scenario, we aim to improve heart preservation after a warm ischemic period of 20 min by testing different settings of myocardial protective strategies. Pig hearts were collected from a slaughterhouse and assigned to one of the five experimental groups: baseline (BL), cold cardioplegia (CC), cold cardioplegia + adenosine (CC-ADN), normothermic cardioplegia (NtC + CC) or normothermic cardioplegia + cold cardioplegia + adenosine (NtC-ADN + CC). After treatment, tissue biopsies were taken to assess mitochondrial morphology, antioxidant enzyme activity, lipid peroxidation and cytokine and chemokine expressions. NtC + CC treatment significantly prevented mitochondria swelling and mitochondrial cristae loss. Moreover, the antioxidant enzyme activity was lower in this group, as was lipid peroxidation, and the pro-inflammatory chemokine GM-CSF was diminished. Finally, we demonstrated that normothermic cardioplegia preserved mitochondria morphology, thus preventing oxidative stress and the subsequent inflammatory response. Therefore, normothermic cardioplegia is a better approach to preserve the heart after a warm ischemia period, with respect to cold cardioplegia, before transplantation.

Details

Language :
English
ISSN :
20763921
Volume :
11
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Antioxidants
Publication Type :
Academic Journal
Accession number :
edsdoj.5fa89215e2ca49e1934c85159e5a0b42
Document Type :
article
Full Text :
https://doi.org/10.3390/antiox11030476