Static Cold Storage of Brain Dead Donor Hearts: Can ¡®Pharmacological Conditioning¡¯ Overcome Primary Graft Failure?

详细信息    查看全文

• 作者：G. Kumarasinghe¹ ; ² ; L. Gao¹ ; M. Hicks¹ ; A. Jabbour¹ ; ² ; A. Doyle¹ ; A. Iyer¹ ; ² ; P. Macdonald¹ ; ²
• 刊名：The Journal of Heart and Lung Transplantation
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：32
• 期：4_supp_S
• 页码：S158-S159
• 全文大小：323 K

文摘

| Figures/TablesFigures/Tables

Purpose

Static cold storage of hearts from brain dead donors is still the mainstay in cardiac transplantation. The risk of ischaemia-reperfusion injury (IRI) and primary graft failure (PGF) are significant disadvantages of this method. We found that three ¡®conditioning¡¯ agents-Glyceryl trinitrate (G), Erythropoietin€ and Zoniporide (Z), when added to standard preservation solutions, attenuate IRI in rat hearts. We aimed to test their efficacy in hearts from brain dead rats in prolonged cold storage.

Methods and Materials

Rats were subjected to brain death (BD) by inflation of a subdural embolectomy catheter. Invasive haemodynamic changes are shown in . Cardiac function was assessed on an isolated working heart model (IWHM), then hearts arrested and preserved in Celsior for 1, 3 or 6 hours (n=6 each sub-group). Additional hearts from BD donors were arrested and stored for 3 or 6 hours using Celsior with G+E+Z (n=6 for 3h, 6h) and function re-assessed on an IWHM.

Results

BD hearts had inferior recovery of cardiac output (CO) cf with shams. Supplementing Celsior with G+E+Z significantly improved CO in BD hearts (p<0.0003 3h, 6h). Pathology analyses are underway.

Conclusions

G, E & Z that activate ¡®conditioning¡¯ pathways significantly improve recovery of BD rat hearts after prolonged static cold storage. This data warrants assessing these strategies clinically. []