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Updated: Aug 18, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Continuous retrograde warm blood reperfusion reduces cardiac troponin I release after heart transplantation: a
R Fiocchi1, A Vernocchi, C Mammana
1Cardiac Surgery and Clinical Pathology Department, Ospedali Riuniti di Bergamo, Italy. hearttranspl@cyberg.it
Insights
Continuous retrograde warm blood reperfusion significantly reduces cardiac troponin I release after heart transplantation, especially with longer ischemic times. This cardioprotective technique offers better myocardial protection compared to no reperfusion.
Area of Science:
- Cardiology
- Cardiac Surgery
- Transplantation Medicine
Background:
- Cardiac troponin I (cTn-I) is a biomarker for assessing myocardial injury during cardiac surgery.
- Evaluating cardioprotective strategies in heart transplantation (HTx) is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the efficacy of continuous retrograde warm blood reperfusion in protecting the myocardium during HTx.
- To assess the correlation between donor heart ischemic time and cardiac biomarker release post-transplantation.
Main Methods:
- A randomized controlled trial involving 42 HTx patients.
- Measurement of cardiac troponin I (cTn-I) and creatine kinase-MB (CK-MB) levels.
- Comparison between continuous retrograde warm blood reperfusion and no reperfusion after cold cardioplegia.
Main Results:
- A significant linear correlation was observed between donor heart ischemic time and cTn-I/CK-MB release.
- cTn-I release was significantly lower in patients receiving warm retrograde cardioplegia when ischemic time exceeded 90 minutes.
- No significant differences were found for CK-MB, total CK, or myoglobin levels between groups.
Conclusions:
- Postoperative cTn-I release is a valuable indicator of ischemic cardiac damage following HTx.
- Continuous retrograde warm blood cardioplegia offers superior myocardial protection compared to no reperfusion for ischemic times longer than 90 minutes.
Abstract:
During heart surgery, cardiac troponin I (cTn-I) measurement provides a tool to evaluate different cardioprotective techniques. To investigate myocardial protection during heart transplantation (HTx), cTn-I and creatine kinase (CK)-MB release was measured in 42 patients randomized to receving either continuous retrograde warm blood reperfusion or no reperfusion after cold cardioplegia. A significant linear correlation was found between donor heart ischemic time and peaks and the area under the curve of cTn-I and CK-MB release. In patients with an ischemic time longer than 90 min, cTn-I release was significantly lower in those receiving continuous retrograde warm cardioplegia than in controls. No significant difference was observed for CK-MB, tCK, and myoglobin. Our data suggest that the measurement of postoperative cTn-I release may provide a method to evaluate ischemic cardiac damage after HTx. When the ischemic time is longer than 90 min, warm retrograde blood cardioplegia provides better myocardial protection than no reperfusion.
