Objective and noninvasive metabolic characterization of donor hearts by phosphorous-31 magnetic resonance spectroscopy.
OBJECTIVE
The authors performed a multi-institutional, prospective, blind study on hearts from local donors to validate the feasibility and accuracy of the metabolic evaluation of human hearts by phosphorus-31 ( P) magnetic resonance spectroscopy (MRS) before transplantation.


METHODS
Twenty-one hearts were separated into two groups according to a transplantation score (TS) on the basis of the current clinical and echocardiographic evaluation as follows: TS1 (n=7), grafts for United Network for Organ Sharing (UNOS) 1 patients only; and TS2 (n=14), grafts suitable for UNOS 2 patients. All hearts were cold preserved with Celsior and underwent ex situ P MRS to measure ratios of various high-energy phosphate metabolites and the intracellular pH (pHi).


RESULTS
The total duration of the MRS procedure was 32 min, thereby not unacceptably increasing the total ischemic time for the transplanted grafts. Phosphocreatine (PCr) and inorganic phosphate (Pi ) was significantly different between the two groups (0.95+/-0.29 for TS1 and 2.05+/-0.74 for TS2). The difference in pHi was also significant (7.44+/-0.13 for TS1 and 7.64+/-0.19 for TS2).


CONCLUSIONS
Determination of PCr-Pi and pHi as markers of ischemic injury before transplantation can be considered as an objective and accurate criterion for the decision to accept or refuse heart grafts for transplantation.
Kober
Frank
F
Centre de Resonance Magnetique Biologique et Medicale, Faculte de Medecine, Marseille, France. frank.kober@medecine.univ-mrs.fr.
Caus
Thierry
T
Riberi
Alberto
A
Confort-Gouny
Sylviane
S
LeFur
Yann
Y
Izquierdo
Marguerite
M
Ranjeva
Jean-Philippe
JP
Viout
Patrick
P
Mesana
Thierry
T
Metras
Dominique
D
Cozzone
Patrick J
PJ
Bernard
Monique
M
D000328:Adult; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D016027:Heart Transplantation; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000000981:diagnostic imaging; D009206:Myocardium / Q000378:metabolism*; D010759:Phosphorus Isotopes; D011446:Prospective Studies; D011877:Radionuclide Imaging; D014019:Tissue Donors
D010759:Phosphorus Isotopes