title: Preimplantation alteration of adenine nucleotides in cryopreserved heart valves.
abstract: To assess the initial metabolic phase of cellular injury from cardiac valve processing, high-energy phosphate concentrations were analyzed in valve leaflets subsequent to critical processing steps. Using a porcine model, valves were processed in a manner identical to human homografts, with 58 randomly assigned to five groups representing distinct preparation phases. Group I (controls) sustained 40 minutes of warm ischemia concluded by liquid nitrogen immersion. Remaining groups similarly endured 40 minutes of ischemia, but were subsequently prepared according to stepwise design: II, warm ischemia + 24 hours of 4 degrees C ischemia; III, warm ischemia + 24 hours of 4 degrees C antibiotic disinfection; IV, warm ischemia + 24 hours at 4 degrees C (without antibiotics) + cryopreservation (-1 degrees C/min cryoprotected freezing); and V, warm ischemia+disinfection+cryopreservation. At each regimen's conclusion leaflet extracts were assayed by high-performance liquid chromatography for high-energy adenine nucleotides (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate) and catabolites. A 47% and 86% decrease in cellular adenosine triphosphate level was observed in group III and group V leaflets, respectively. The level of total adenine nucleotides was maintained up to cryopreservation; thereafter a 74% decrease was noted. Catabolite analysis confirmed incomplete degradation of adenine nucleotides indicating cellular metabolic resilience throughout standard homograft preparation in valves previously exposed to 40 minutes of warm ischemia.
authors.affiliation: Georgetown University School of Medicine, Washington, DC.
authors.forename: P W
authors.initials: PW
authors.lastname: Domkowski
authors.forename: R H
authors.initials: RH
authors.lastname: Messier
authors.forename: D G
authors.initials: DG
authors.lastname: Crescenzo
authors.forename: H S
authors.initials: HS
authors.lastname: Aly
authors.forename: A S
authors.initials: AS
authors.lastname: Abd-Elfattah
authors.forename: S L
authors.initials: SL
authors.lastname: Hilbert
authors.forename: R B
authors.initials: RB
authors.lastname: Wallace
authors.forename: R A
authors.initials: RA
authors.lastname: Hopkins
mesh_terms: D000227:Adenine Nucleotides / Q000032:analysis*; D000244:Adenosine Diphosphate / Q000032:analysis; D000249:Adenosine Monophosphate / Q000032:analysis; D000255:Adenosine Triphosphate / Q000032:analysis; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002851:Chromatography, High Pressure Liquid; D015925:Cryopreservation; D005260:Female; D006351:Heart Valves / Q000737:chemistry* / Q000637:transplantation; D013552:Swine; D013696:Temperature
chemical_list: D000227:Adenine Nucleotides; D000900:Anti-Bacterial Agents; D000249:Adenosine Monophosphate; D000244:Adenosine Diphosphate; D000255:Adenosine Triphosphate