Myocardial ultrastructure and hemodynamic changes of donor heart preserved in normothemic beating status

doi:10.3969/j.issn.2095-4344.2013.05.014

Abstract

Abstract:

BACKGROUND: For heart transplantation, the development trend of myocardial preservation method has changed from cold static storage to normal beating physiological status for prolonging preservation time and improving the quality of donor heart. Theoretically, the beating donor heart perfusion preservation at normal temperature is the preservation method that most close to the normal life state with a good potential for development.
OBJECTIVE: To observe the changes of myocardial ultrastructure and left ventricular hemodynamics of beating donor heart with continuous blood perfusion at normal temperature.
METHODS: Twenty-four Guangxi Bama miniature pigs were randomly divided into two groups: non-cardioplegia preservation group and cold preservation group, six pigs in each group. In the non-cardioplegia preservation group, the donor hearts were harvested in beating state and perfused continuously with normothermic oxygened blood. In the cold preservation group, the donor hearts were perfused with cold crystalliod cardioplegia for harvesting and persevered in 0-4 ℃ UW solution. After 8 hours, the donor hearts were transplanted to the recipients. After the transplanted aorta declamping for 3 hours, the left ventricular systolic pressure, left ventricular diastolic pressure, left ventricular mean pressure, left ventricular end-diastolic pressure, and the maximum rising and falling rate of left ventricular pressure of the donor hearts were observed. The changes of heart rhythm after transplantation, the number of required defibrillation and weaned from cardiopulmonary bypass after aortic declamping for 3 hours were recorded. The left ventricular anterolateral wall myocardial tissues of the donor hearts were obtained after aortic declamping for 3 hours to observe the changes of mitochondria and sarcolemma.
RESULTS AND CONCLUSION: The left ventricular systolic pressure, left ventricular mean pressure, left ventricular end-diastolic pressure and the maximum rising and falling rate of left ventricular pressure in the non-cardioplegia preservation group were significantly prior to those in the cold preservation group (P < 0.05). After aortic declamping, all donor hearts could maintain sinus rhythm in the non-cardioplegia preservation group, but only one case in the cold preservation group recovered sinus rhythm spontaneously. After aortic declamping for 3 hours, five hearts could wean off extracorporeal circulation in the non-cardioplegia group, but only one case in the cold preservation group. The myocardial ultrastructure of the non-cardioplegia preservation group was superior to that of the cold preservation group. Keeping donor heart in beating status with normothermic perfusion can provide effective myocardial preservation and fit for long-term preservation.

Key words: organ transplantation, heart and lung transplantation, myocardial protection, continuous perfusion, beating heart, cold preservation, hemodynamics, myocardial ultrastructure, National Natural Science Foundation of China, photographs-containing paper of organ transplantation

CLC Number:

R318

Yang Yong, Lin Hui, Wen Zhao-ke, Huang Ai-lan, Wen Hong, Huang Guo-yong, Hu Yan-yan. Myocardial ultrastructure and hemodynamic changes of donor heart preserved in normothemic beating status[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(5): 851-858.

Figures/Tables 4

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