Coronary oxygen persufflation for heart preservation in pigs: analyses of endothelium and myocytes.
BACKGROUND
Coronary oxygen persufflation (COP) has been shown to prolong heart preservation time up to 14 hr in a mature pig model, with excellent recovery after orthotopic transplantation. The aim of the present study was to assess the structural, metabolic, and functional myocardial and endothelial integrity after COP in mature pig hearts.


METHODS
Cardioplegic arrest was induced by original crystalloid Bretschneider solution (HTK 3h, n=6), modified Bretschneider solution (mHTK+COP, n=6), or University of Wisconsin solution (UW+COP, n=6). Hearts were stored for 3 (HTK 3h) or 14 hr (mHTK+COP, UW+COP) at 0 degrees to 1 degrees C. In addition, COP hearts were persufflated. After heterotopic transplantation and reperfusion for 7 days, hearts were analyzed by light microscopy or electron microscopy for structural injuries. Endothelial function, cardiac enzymes, metabolic parameters, and myocardial water content (MWC) were determined. Six recipient hearts served as controls.


RESULTS
Quantitative light microscopic analyses and semiquantitative electron microscopic analyses showed an equal amount of damage in all groups including HTK 3h hearts. No rejection was observed. Substance P induced an equal dilatation in all hearts. Serum levels of cardiac enzymes were similar in all groups, but energy-enriched phosphates were significantly reduced, and MWC was augmented in the HTK 3h hearts and in the UW+COP hearts, in contrast to the mHTK+COP transplants.


CONCLUSIONS
The lack of structural defects related to the COP technique, similar endothelial function, and an even better metabolic state of the mHTK+COP hearts versus HTK 3h hearts demonstrate the efficacy of the COP technique for prolongation of myocardial preservation time up to 14 hr.
Kuhn-Régnier
Ferdinand
F
Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany. ferdinand.kuhn-regnier@medizin.uni-koeln.de
Bloch
Wilhelm
W
Tsimpoulis
Ilias
I
Reismann
Marc
M
Dagktekin
Oguzan
O
Jeschkeit-Schubbert
Stefanie
S
Funcke
Claudia
C
Fries
Jochen W U
JW
Addicks
Klaus
K
de Vivie
Ernst R
ER
Fischer
Jürgen H
JH
D000227:Adenine Nucleotides / Q000378:metabolism; D000241:Adenosine / Q000494:pharmacology; D000255:Adenosine Triphosphate / Q000378:metabolism; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D001834:Body Water / Q000378:metabolism; D004727:Endothelium / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D005947:Glucose; D005978:Glutathione / Q000494:pharmacology; D006321:Heart / Q000187:drug effects; D016027:Heart Transplantation; D007327:Insufflation; D007328:Insulin / Q000494:pharmacology; D008353:Mannitol; D009206:Myocardium / Q000201:enzymology / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D032383:Myocytes, Cardiac / Q000473:pathology / Q000648:ultrastructure; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010100:Oxygen; D011189:Potassium Chloride; D011343:Procaine; D011887:Raffinose / Q000494:pharmacology; D013552:Swine; D013997:Time Factors; D016042:Transplantation, Heterotopic
D000227:Adenine Nucleotides; C039984:Bretschneider cardioplegic solution; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D000255:Adenosine Triphosphate; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose; D010100:Oxygen