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Updated: Aug 19, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
A new hydroxyl radical scavenger "EPC" on cadaver heart transplantation in a canine model
K Hisamochi1, T Morimoto, K Bando
1Second Department of Surgery, Okayama University Medical School, Japan.
Insights
This study shows that using EPC, a hydroxyl radical scavenger, can improve the outcomes of heart transplantation by reducing injury. Hearts resuscitated with EPC support demonstrated better function post-transplant compared to controls.
Area of Science:
- Cardiology
- Transplantation Immunology
- Biomedical Engineering
Background:
- Heart transplantation is a critical treatment for end-stage heart failure.
- Preserving organ viability during procurement and transplantation remains a significant challenge.
- Ischemic and reperfusion injury can compromise graft function and long-term survival.
Purpose of the Study:
- To evaluate the efficacy of a hydroxyl radical scavenger, EPC, in reducing injury during resuscitation of arrested hearts.
- To determine if EPC improves outcomes following orthotopic heart transplantation.
- To assess the viability of transplanting hearts resuscitated after cardiac arrest using cardiopulmonary bypass (CPB).
Main Methods:
- Canine hearts were subjected to cardiac arrest and cooled to 15°C using CPB.
- Hearts were treated with either EPC or a placebo (control group).
- Orthotopic heart transplantation was performed, and cardiac function was assessed post-transplant.
Main Results:
- EPC-treated hearts were successfully weaned from CPB without inotropic support, unlike control hearts (P=0.001).
- Cardiac function (Emax) was significantly better preserved in the EPC group 1 hour post-transplant (110% vs. 70% of baseline, P=0.02).
- EPC treatment reduced post-transplant reperfusion injury.
Conclusions:
- EPC demonstrates a protective effect against ischemic and reperfusion injury in transplanted hearts.
- EPC may serve as a valuable adjunct in heart transplantation protocols.
- Successful transplantation of arrested and resuscitated hearts is feasible with improved preservation strategies.
Abstract:
This study was performed to determine if an "arrested" heart, resuscitated with cardiopulmonary bypass (CPB) after the cessation of beating, can be successfully transplanted, and whether a hydroxyl radical scavenger EPC can reduce ischemic and reperfusion injury during resuscitation of the arrested heart and following orthotopic heart transplantation. A total of 16 pairs of canines were divided into a control group of eight pairs and an EPC-treated group of eight pairs. Cardiac arrest of the donor heart was induced by the discontinuation of respiratory support after the induction of brain death. The cadaver heart was then resuscitated and core-cooled to myocardial temperature of 15 degrees C using CPB. The donor heart was harvested using cold cardioplegia and orthotopically transplanted. All of the transplanted hearts in the EPC group were weaned from CPB without any inotropic support after 60 min of bypass support, whereas all the animals in the control group required 5 micrograms/kg/min dopamine (P = 0.001). Moreover, cardiac function (Emax) 1 h after orthotopic heart transplantation was better preserved in the EPC group than in the control group, at 110 +/- 36% vs. 70 +/- 21% of the post brain death values (P = 0.02) These findings demonstrate that EPC reduces posttransplant reperfusion injury, and thus it may prove to be a valuable adjunct in this challenging model.
