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- Title
Hypothermic continuous machine perfusion improves metabolic preservation and functional recovery in heart grafts.
- Authors
Van Caenegem, Olivier; Beauloye, Christophe; Vercruysse, Jonathan; Horman, Sandrine; Bertrand, Luc; Bethuyne, Noëlla; Poncelet, Alain J; Gianello, Pierre; Demuylder, Peter; Legrand, Eric; Beaurin, Gwen; Bontemps, Françoise; Jacquet, Luc M; Vanoverschelde, Jean-Louis
- Abstract
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. Sixteen 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 min. Energetic metabolism was quantified at baseline, postpreservation, and postreperfusion by measuring lactate and high-energy phosphates. The contractility index ( CI) was assessed both in vivo prior to cardioplegia and during reperfusion. Following reperfusion, the hearts preserved using CS exhibited higher lactate levels (56.63 ± 23.57 vs. 11.25 ± 3.92 μmol/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 + /-9 ml/100 g/min heart; P = ns). CI decreased in the CS group, yet being well-preserved in the MP group. Compared with CS, MP resulted in improved preservation of the energy state and more successful functional recovery of heart graft.
- Subjects
HEART diseases; CARDIOPULMONARY system; SURGICAL flaps; TRANSPLANTATION of organs, tissues, etc.; SURGERY
- Publication
Transplant International, 2015, Vol 28, Issue 2, p224
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12468