Document Detail


High-risk heart grafts: effective preservation with Celsior solution.
MedLine Citation:
PMID:  16550309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Celsior solution has already proved effective in heart graft preservation because it reduces myocardial edema, prevents free radical damage, and limits calcium overload. The aim of this study was to evaluate the effectiveness of Celsior solution as myocardial protection in high-risk transplantation. Hospital charts and follow-up data of 200 consecutive heart recipients (162 males, 38 females, mean age 47.4 +/- 12.6 years) were reviewed. Patients were divided into two groups: group A (73 patients) included recipients of high-risk grafts (at least two of the following: age >45; female sex; high preretrieval inotropic support, viz. dobutamine or dopamine >10 microg/kg per minute and/or infusion of norepinephrine regardless of its dosage; size mismatch >20%; ischemia time >180 min) and group B (127 patients) included recipients of standard grafts. Quality of preservation was assessed through enzyme release, echocardiographic evaluation, the need for inotropic support or pacemaker, and histology of biopsy samples. Hospital and 1-year mortality were also evaluated. Comparisons between the two groups were made through univariate analysis. Study groups proved homogeneous as to recipient age, pretransplant cardiomyopathy, status at transplantation, mean panel reactive antibodies, and redo cardiac surgery. Hospital mortality was 8% (11% vs 6.3%, P = 0.18) while 1-year mortality reached 12% (15.1% vs 10.2%, P = 0.6) without significant difference between groups. Graft performance as described by the need for inotropic support and/or pacemaker as well as echocardiography (left and right ventricular ejection fraction) proved comparable. There were no significant differences as to histology findings and patterns of enzyme release. Celsior provides optimal myocardial preservation in both standard and high-risk procedures. Such advances help to enhance donor pool expansion.
Authors:
Luca Salvatore De Santo; Cristiano Amarelli; Gianpaolo Romano; Alessandro Della Corte; Ciro Maiello; Bruno Giannolo; Claudio Marra; Marisa De Feo; Michelangelo Scardone; Maurizio Cotrufo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart and vessels     Volume:  21     ISSN:  0910-8327     ISO Abbreviation:  Heart Vessels     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-21     Completed Date:  2007-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  89-94     Citation Subset:  IM    
Affiliation:
Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, V. Monaldi Hospital, Naples, Italy. lucas.desanto@unina2.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Disaccharides
Electrolytes
Female
Glutamates
Glutathione
Heart Transplantation*
Histidine
Humans
Male
Mannitol
Middle Aged
Organ Preservation Solutions*
Quality Control
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
0/Celsior; 0/Disaccharides; 0/Electrolytes; 0/Glutamates; 0/Organ Preservation Solutions; 69-65-8/Mannitol; 70-18-8/Glutathione; 71-00-1/Histidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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