Heart preservation using continuous ex vivo perfusion improves viability and functional recovery

Area of Science:

• Cardiovascular Surgery
• Organ Transplantation
• Biomedical Engineering

Background:

• Cold static storage (CS) is standard for heart preservation but leads to early graft dysfunction.
• Continuous perfusion (CP) offers a potential alternative to improve ex vivo heart graft viability.

Purpose of the Study:

• To compare the efficacy of CP versus CS in preserving canine heart grafts.
• To assess biochemical markers and functional recovery after 6-hour preservation.

Main Methods:

• Canine hearts were preserved using CP (n=9) or CS (n=9) for 6 hours.
• Intramyocardial pH, ATP, caspase-3, MDA, and ET-1 levels were measured.
• Myocardial function was evaluated post-reperfusion using hemodynamic parameters.

Main Results:

• CP hearts maintained higher tissue pH and ATP levels compared to CS hearts.
• CP significantly reduced markers of oxidative injury (MDA) and apoptosis (caspase-3).
• CP demonstrated superior functional recovery post-reperfusion, with reduced myocardial injury.

Conclusions:

• CP mitigates tissue acidosis and energy depletion associated with CS.
• CP attenuates reperfusion injury, including oxidative stress and apoptosis.
• Continuous perfusion enhances myocardial recovery, despite transient edema, compared to static cold storage.