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Updated: Aug 17, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Effects of crystalloid, blood and Celsior solutions on porcine coronary endothelial function after heart
Louis P Perrault1, Ismaïl El-Hamamsy, Eric Dumont
1Department of Surgery and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada. lpperau@icm.umontreal.ca
Insights
Celsior cardioplegic solution best preserves endothelial function and reduces coronary intimal hyperplasia after heart transplantation compared to crystalloid and blood solutions. This may improve long-term cardiac allograft vasculopathy and graft survival.
Area of Science:
- Cardiology
- Transplantation Immunology
- Vascular Biology
Background:
- Coronary endothelial dysfunction is an early complication of heart transplantation, predicting cardiac allograft vasculopathy.
- Cardioplegic solutions used during graft harvesting may induce endothelial injury.
- Assessing the impact of different cardioplegic solutions on early post-transplant endothelial function and intimal hyperplasia is crucial.
Purpose of the Study:
- To evaluate the effects of crystalloid, blood, and Celsior cardioplegic solutions on endothelial function and intimal hyperplasia one month after heart transplantation.
- To compare the efficacy of different cardioplegic solutions in preserving coronary endothelial function and preventing neointimal proliferation.
Main Methods:
- A heterotopic heart transplantation model in pigs was utilized.
- Epicardial coronary arteries from native and allograft hearts were analyzed in organ chambers one month post-transplant.
- Endothelium-dependent relaxations to serotonin, bradykinin, and calcium ionophore were assessed, alongside histomorphometric evaluation of coronary neointimal proliferation.
Main Results:
- All tested cardioplegic solutions significantly decreased endothelium-dependent relaxations to serotonin and calcium ionophore compared to controls.
- The crystalloid group showed significantly reduced endothelium-dependent relaxations to bradykinin compared to Celsior, blood groups, and controls.
- Severe intimal hyperplasia was significantly lower in the Celsior group compared to the crystalloid and blood groups.
Conclusions:
- Celsior cardioplegic solution demonstrates superior preservation of endothelial function and a lower incidence of severe coronary intimal hyperplasia post-heart transplantation compared to crystalloid and blood solutions.
- These findings suggest Celsior may reduce the long-term incidence of cardiac allograft vasculopathy and improve graft survival.
- Celsior represents a preferred cardioplegic solution for heart transplantation based on early functional and structural outcomes.
Background:
Coronary endothelial dysfunction occurs early after heart transplantation and predicts the development of cardiac allograft vasculopathy. Cardioplegic solutions may cause endothelial injury. The present study aimed to assess the effects of cardioplegic solutions (crystalloid, blood and Celsior) used at the time of graft harvesting on endothelial function and intimal hyperplasia 1 month after heart transplantation.
Methods:
A porcine heterotopic heart transplantation model was used. Three experimental groups were studied: crystalloid, blood and Celsior solutions were used for induction of cardiac arrest. Epicardial coronary arteries of native and allograft hearts were studied 1 month after transplantation in organ chambers. Endothelium-dependent relaxations to serotonin, bradykinin and calcium ionophore were assessed. Coronary neointimal proliferation was evaluated using histomorphometric studies.
Results:
Endothelium-dependent relaxations to serotonin and to calcium ionophore were significantly decreased in all 3 experimental groups vs controls (p<0.05). Endothelium-dependent relaxations to bradykinin were significantly reduced in the crystalloid group compared with the Celsior and blood groups and controls (p<0.05). There was a significantly lower rate of severe intimal hyperplasia in the Celsior group compared to the crystalloid and blood groups (p<0.05).
Conclusion:
Celsior cardioplegic solution represents the solution of choice in terms of preservation of endothelial function and lower incidence of severe coronary intimal hyperplasia following transplantation compared with crystalloid and blood cardioplegia solutions. These early results could translate into a reduction of the long-term incidence of cardiac allograft vasculopathy and improve graft survival.
