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Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Intact coronary and myocardial functions after 24 hours of non-ischemic heart preservation
Guangqi Qin1, Björn Wohlfart1, Long Zuo1
1Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
Insights
Non-ischemic heart preservation (NIHP) for 24 hours maintains coronary artery endothelium-dependent relaxation and myocardial contractility. This method effectively prevents edema in preserved hearts.
Area of Science:
- Cardiology
- Transplantation Medicine
- Physiology
Background:
- Preservation of donor hearts is critical for successful transplantation.
- Evaluating the functional integrity of preserved organs is essential.
Purpose of the Study:
- To assess endothelium-dependent relaxation (EDR) in coronary arteries.
- To evaluate myocardial contractility after 24-hour non-ischemic heart preservation (NIHP).
Main Methods:
- Explanted pig hearts underwent 24-hour NIHP using a specialized cardioplegic solution.
- Coronary artery segments were tested for EDR using Thromboxane A2 and Substance P.
- Myocardial contractility was assessed using a right ventricular trabecula preparation.
- Fresh hearts served as controls; myocardial water content was measured.
Main Results:
- No significant difference in EDR between NIHP and control groups (91.2% vs 93.1%).
- Myocardial contractility parameters (force, potentiation, calcium recirculation) were comparable.
- Myocardial water content showed no significant difference, indicating no edema.
Conclusions:
- 24-hour NIHP preserves coronary artery EDR and myocardial contractility.
- NIHP does not induce myocardial edema.
- This preservation method is a viable option for maintaining heart function.
Abstract:
Objectives. The aim of this study was to investigate endothelium dependent relaxation (EDR) in coronary artery and the myocardial contractility after 24 h of non-ischemic heart preservation (NIHP). Design. Explanted cardioplegic hearts from six pigs were preserved by NIHP for 24 h. The perfusion medium consisted of an albumin containing hyperoncotic cardioplegic nutrition-hormone solution with erythrocytes to a hematocrit of 10%. Coronary artery ring segments were then studied in organ baths. Thromboxane A2 was used for vasocontraction and Substance P to elicit endothelium dependent relaxation. A heart trabecula from the right ventricle was mounted in an organ bath and a special stimulation protocol was used to characterize myocardial contractility. Fresh cardioplegic hearts from 11 pigs were used as controls. The water content of the hearts was calculated. Results. There was no significant difference between NIHP and fresh controls regarding EDR (91.2 ± 1.2% vs 93.1 ± 1.8%). The contraction force, potentiation and calcium recirculation fraction did not differ between the groups. The water content of the myocardium was 79.3 ± 0.2% for NIHP and 79.5 ± 0.2% for controls. Conclusions. NIHP for 24 h keeps coronary artery EDR and myocardial contractility intact and causes no edema.
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