| Perfusion preservation versus static preservation for cardiac transplantation: effects on myocardial function and metabolism. | |
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MedLine Citation:
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PMID: 18187093 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Continuous perfusion of donor hearts for transplantation has received increasing interest, but the effects on cellular metabolism, myocyte necrosis, and myocardial edema are not well defined. METHODS: Pig hearts were instrumented with sonomicrometry crystals and left ventricular catheters. Left ventricular function was quantified by the pre-load-recruitable stroke work (PRSW) relationship. Hearts were arrested with Celsior solution with 5.5 mM 13C-glucose added, and removed and stored in cold solution (n = 4) or placed in a device providing continuous perfusion of this solution at 10 ml/100 g/min (n = 4). After 4 hours of storage, left atrial samples were frozen, extracted, and analyzed by magnetic resonance spectroscopy. Hearts were then transplanted into recipient pigs and reperfused for 6 hours, with function measured hourly. At the end of the experiment, left ventricular water content and serum creatine kinase-MB isoenzyme levels were measured. RESULTS: Baseline left ventricular function was similar in both groups. During reperfusion, the volume-axis intercept of the PRSW relationship was significantly lower in hearts stored with continuous perfusion (p < 0.05), suggesting reduced contractile impairment. Magnetic resonance spectroscopy revealed a decrease in tissue lactate in hearts that received continuous perfusion. Serum creatine kinase-MB isoenzyme levels were higher hearts that had static storage (30.8 +/- 9.0 vs 13.2 +/- 2.7 ng/ml; p < 0.05). Left ventricular water content was similar in both groups (0.797 +/- 0.012 vs 0.796 +/- 0.014; p = 0.45). CONCLUSIONS: Donor hearts sustain less functional impairment after storage with continuous perfusion. This technique reduces tissue lactate accumulation and myocardial necrosis without increasing myocardial edema and appears promising as a method to improve results of cardiac transplantation. |
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Authors:
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David H Rosenbaum; Matthias Peltz; J Michael DiMaio; Dan M Meyer; Michael A Wait; Matthew E Merritt; W Steves Ring; Michael E Jessen |
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6849583 - Does secondary cardioplegia provide long-term recovery from ischemic injury? 2675543 - 31p nmr studies of the metabolic status of pig hearts preserved for transplantation. 17000303 - Strain-related regional alterations of calcium-handling proteins in myocardial remodeling. |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 27 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-11 Completed Date: 2008-01-31 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
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Languages: eng Pagination: 93-9 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8879, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Disease Models, Animal Heart Transplantation / methods* Hypothermia, Induced / methods* Lactic Acid / metabolism Magnetic Resonance Spectroscopy Myocardial Contraction / physiology Myocardium / metabolism* Organ Preservation / methods* Organ Preservation Solutions / pharmacology* Perfusion / methods* Swine Ventricular Function / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Organ Preservation Solutions; 50-21-5/Lactic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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