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Hypothermic continuous machine perfusion improves metabolic preservation and functional recovery in heart grafts.
MedLine Citation:
PMID:  25265884     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The number of heart transplants is decreasing due to organ shortage, yet the donor pool could be enlarged by improving graft preservation. Hypothermic machine perfusion (MP) has been shown to improve kidney, liver, or lung graft preservation.
METHOD: 16 pig hearts were recovered following cardioplegia and randomized to two different groups of 4-hour preservation using either static cold storage (CS) or MP (Modified LifePort© System, Organ Recovery Systems©, Itasca, Il). The grafts then underwent reperfusion on a Langendorff for 60 minutes. Energetic metabolism was quantified at baseline, post-preservation, and post-reperfusion by measuring lactate and high-energy phosphates. The contractility index (CI) was assessed both in vivo prior to cardioplegia and during reperfusion.
RESULTS: Following reperfusion, the hearts preserved using CS exhibited higher lactate levels (56.63±23.57 vs. 11.25±3.92μmol/g; p <0.001), increased adenosine monophosphate/adenosine triphosphate (AMP/ATP) ratio (0.4±0.23 vs. 0.04±0.04; p <0.001), and lower phosphocreatine/creatine (PCr/Cr) ratio (33.5±12.6 vs. 55.3±5.8; p <0.001). Coronary flow was similar in both groups during reperfusion (107±9 vs. 125+/-9ml/100g/min heart; p=ns). CI decreased in the CS group, yet being well-preserved in the MP group.
CONCLUSION: Compared to CS, MP resulted in improved preservation of the energy state and more successful functional recovery of heart graft This article is protected by copyright. All rights reserved.
Authors:
Olivier Van Caenegem; Christophe Beauloye; Jonathan Vercruysse; Sandrine Horman; Luc Bertrand; Noëlla Bethuyne; Alain J Poncelet; Pierre Gianello; Peter Demuylder; Eric Legrand; Gwen Beaurin; Françoise Bontemps; Luc M Jacquet; Jean-Louis Vanoverschelde
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-29
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  -     ISSN:  1432-2277     ISO Abbreviation:  Transpl. Int.     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-30     Completed Date:  -     Revised Date:  2014-10-1    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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