Related Experiment Videos
New solution for prolonged myocardial preservation for transplantation
H Schwalb1, L Grinberg, E Yaroslavsky-Houminer
1University of Cape Town, South Africa.
Insights
The Jerusalem-Cape Town Solution (JCT) effectively preserves ischemic hearts for up to 12 hours. At 20 hours, JCT demonstrates superior heart preservation compared to HTK and University of Wisconsin solutions.
Area of Science:
- Cardiology
- Organ Preservation
- Transplantation Medicine
Background:
- A novel intracellular cardioplegic solution, the Jerusalem-Cape Town Solution (JCT), has been developed for prolonged heart storage.
- JCT is formulated to mitigate hypothermic cell swelling, intracellular acidosis, and reperfusion injury while providing substrates for energy regeneration.
Purpose of the Study:
- To evaluate the efficacy of the JCT solution in preserving rat hearts during extended cold storage.
- To compare JCT's performance against established cardioplegic solutions like Bretschneider's HTK and the University of Wisconsin solution.
Main Methods:
- Rat hearts were preserved using a Langendorff model, undergoing 20 hours of cold storage (5-6°C) after cardioplegic infusion.
- Hearts were divided into three groups, receiving JCT, HTK, or University of Wisconsin solution, followed by 60 minutes of reperfusion.
- Hemodynamic recovery, including coronary artery flow and left ventricular developed pressure, was assessed.
Main Results:
- JCT demonstrated significantly better recovery of coronary artery flow and left ventricular developed pressure (LVDP) compared to HTK after 20 hours of storage.
- Heart contractility, measured by LVDP x heart rate, was significantly higher with JCT than with HTK or UW solution at 20 hours.
- No significant difference in contractility recovery was observed between JCT and HTK for storage durations up to 12 hours.
Conclusions:
- The JCT solution is effective for preserving ischemic hearts for up to 12 hours, comparable to HTK.
- JCT exhibits superior performance over HTK and University of Wisconsin solutions for 20-hour isolated ischemic heart storage.
Background:
A solution for prolonged cold storage of the heart has been developed. The Jerusalem-Cape Town Solution (JCT) is an "intracellular" type cardioplegic solution and is formulated to (1) minimize hypothermic-induced cell swelling, (2) diminish intracellular acidosis, (3) prevent the expansion of the interstitial space during the reperfusion, (4) protect against oxygen free radical injury during early reperfusion, and (5) provide substrates for regenerating high-energy phosphates.
Methods:
With a Langendorff model, rat hearts were subjected to 15 minutes of perfusion with Krebs-Henseleit, 10 minutes of cardioplegic infusion and 20 hours of cold storage (5 degrees to 6 degrees C). Hearts were reperfused for 60 minutes and hemodynamic recovery was assessed. The hearts were assigned to three groups (eight hearts in each), according to the cardioplegic solution used: group 1, JCT; group 2, Bretschneider's HTK cardioplegic solution; and group 3 University of Wisconsin cold storage solution.
Results:
After 60 minutes of reperfusion, the recovery of the coronary artery flow in group 1 (JCT) was significantly better than in group 2, and slightly better than in group 3 (64% +/- 8.9%, 47.2% +/- 11.6%, 52.5% +/- 19.9%, mean +/- SD, respectively; group 1 versus group 2, p < 0.01). The recovery of the left ventricular developed pressure (LVDP) was significantly better in group 1 compared with group 2 and group 3 (60.2% +/- 14.5%, 41.1% +/- 12.6% and 36.5% +/- 10.1%, respectively; p < 0.01). The recovery of the heart contractility expressed by the product of LVDP and the heart rate (LVDP x heart rate) was significantly higher in group 1 than in group 2 and group 3 (47.5% +/- 3.4%, 23.6% +/- 9.6%, and 28.7% +/- 8.3%, respectively, p < 0.001). In hearts stored for 12 hours in JCT or HTK, the recovery of the heart contractility did not differ significantly (73.4% +/- 12.7% or 70.8% +/- 30.8%, respectively). Modified reperfusion aimed to improve postischemic heart recovery did not bring significant changes in cardiac mechanical function but resulted in an increase in postischemic coronary artery flow recovery in hearts reperfused with amino acid-enriched buffer.
Conclusions:
The JCT solution is effective (as well as HTK) in preserving the ischemic hearts for up to 12 hours. It is superior to HTK or University of Wisconsin solution at 20 hours of isolated ischemic storage.