Effects of crystalloid, blood and Celsior solutions on porcine coronary endothelial function after heart transplantation.
BACKGROUND
Coronary endothelial dysfunction occurs early after heart transplantation and predicts the development of cardiac allograft vasculopathy. Cardioplegic solutions may cause endothelial injury. The present study aimed to assess the effects of cardioplegic solutions (crystalloid, blood and Celsior) used at the time of graft harvesting on endothelial function and intimal hyperplasia 1 month after heart transplantation.


METHODS
A porcine heterotopic heart transplantation model was used. Three experimental groups were studied: crystalloid, blood and Celsior solutions were used for induction of cardiac arrest. Epicardial coronary arteries of native and allograft hearts were studied 1 month after transplantation in organ chambers. Endothelium-dependent relaxations to serotonin, bradykinin and calcium ionophore were assessed. Coronary neointimal proliferation was evaluated using histomorphometric studies.


RESULTS
Endothelium-dependent relaxations to serotonin and to calcium ionophore were significantly decreased in all 3 experimental groups vs controls (p<0.05). Endothelium-dependent relaxations to bradykinin were significantly reduced in the crystalloid group compared with the Celsior and blood groups and controls (p<0.05). There was a significantly lower rate of severe intimal hyperplasia in the Celsior group compared to the crystalloid and blood groups (p<0.05).


CONCLUSIONS
Celsior cardioplegic solution represents the solution of choice in terms of preservation of endothelial function and lower incidence of severe coronary intimal hyperplasia following transplantation compared with crystalloid and blood cardioplegia solutions. These early results could translate into a reduction of the long-term incidence of cardiac allograft vasculopathy and improve graft survival.
Department of Surgery and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada. lpperau@icm.umontreal.ca
Louis P
LP
Perrault
Ismaïl
I
El-Hamamsy
Eric
E
Dumont
Olivier
O
Malo
Michel
M
Carrier
D000818:Animals; D002314:Cardioplegic Solutions; D003331:Coronary Vessels / Q000503:physiopathology*; D004187:Disaccharides; D004573:Electrolytes; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005971:Glutamates; D005978:Glutathione; D016027:Heart Transplantation; D006639:Histidine; D008353:Mannitol; D023421:Models, Animal; D019188:Organ Preservation Solutions; D017680:Potassium Compounds; D013552:Swine; D013997:Time Factors; D014654:Vascular Patency
D002314:Cardioplegic Solutions; C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D019188:Organ Preservation Solutions; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D008353:Mannitol; D006639:Histidine; D005978:Glutathione