Hemodynamic consequences of porcine kidney xenograft reperfusion in cynomolgus monkeys.
BACKGROUND
After xenograft reperfusion, complement activation may lead to generation of anaphylatoxins and cardiocirculatory instability of the recipient.


METHODS
In 13 cynomolgus recipients of either unmodified or human decay accelerating factor transgenic porcine kidneys cardiocirculatory parameters were measured by single indicator transpulmonary thermodilution.


RESULTS
After graft reperfusion, recipient cardiac output decreased by 25.4% (P<0.05), intrathoracic blood volume by 22.8% (P<0.05), extravascular lung water increased slightly (P=n.s.). The impairment in cardiac output was neither influenced by the graft's weight or human decay accelerating factor transgenicity. sC3a and sC5b-9 complement levels in the recipient monkeys showed a sharp peak upon reperfusion.


CONCLUSIONS
After reperfusion a marked and significant cardiodepression accompanied by relative volume depletion were observed. Analysis of volume status ruled out a mere volume shift as the underlying reason for the observed drop in cardiac output. These data may be relevant for the perioperative management of human recipients of discordant xenografts in the future.
Przemeck
M
M
Abt. Anästhesiologie I, Medizinische Hochschule Hannover, 30623 Hannover, Germany.
Vangerow
B
B
Loss
M
M
Schmidtko
J
J
Klempnauer
J
J
Rückoldt
H
H
Piepenbrock
S
S
Winkler
M
M
D000818:Animals; D030801:Animals, Genetically Modified; D001810:Blood Volume; D001834:Body Water / Q000378:metabolism; D018958:CD55 Antigens / Q000235:genetics; D002302:Cardiac Output; D015926:Complement C3a / Q000032:analysis; D015938:Complement Membrane Attack Complex / Q000032:analysis; D006439:Hemodynamics; D006801:Humans; D016030:Kidney Transplantation; D008168:Lung / Q000378:metabolism; D008252:Macaca fascicularis; D012079:Renal Circulation; D015427:Reperfusion Injury / Q000503:physiopathology*; D013552:Swine; D013815:Thermodilution; D014183:Transplantation, Heterologous
D018958:CD55 Antigens; D015938:Complement Membrane Attack Complex; D015926:Complement C3a