Comparison of propofol and isoflurane anesthesia in orthotopic pig-to-baboon cardiac xenotransplantation.
BACKGROUND
Orthotopic pig-to-baboon xenogeneic heart transplantation (oXHTx) is the only accepted preclinical animal model for cardiac xenotransplantation. We compared the hemodynamic stability of a propofol- and isoflurane-based anesthetic regimen during oXHTx.


METHODS
Hearts from 12 hDAF or hCD46 transgenic pigs (Sus scrofa; body weight 7 to 32 kg) were transplanted into baboons (Papio anubis and Papio hamadryas; body weight 9 to 26 kg) in the orthotopic life-supporting position. Animals received a propofol-based intravenous regimen or inhalation anesthesia with isoflurane. Analgesia was achieved with fentanyl in both groups. Systemic hemodynamic variables were measured before, during and after cardiopulmonary bypass (CPB) and the need for inotropic or vasoactive pharmacological support was compared before and after CPB.


RESULTS
Global hemodynamic variables [i.e. heart rate, mean arterial pressure (MAP) and cardiac output] were not significantly different in propofol-anesthetized baboons compared to baboons anesthetized with isoflurane. Baboons anesthetized with isoflurane showed a trend towards less pharmacological support required to achieve an adequate MAP of >60 mmHg after CPB (propofol: epinephrine 0.13 [0.05; 0.16] and norepinephrine 0.15 [0.02; 0.16] microg/kg/min vs. isoflurane: epinephrine 0.05 [0.02; 0.08] and norepinephrine 0.06 [0.02; 0.19] microg/kg/min; no significant difference).


CONCLUSIONS
Propofol and isoflurane appear to provide equal hemodynamic stability in orthotopic cardiac pig-to-baboon xenotransplantation prior to the start of CPB. The trend of a reduced catecholamine support needed after CPB, however, suggests that isoflurane may be the preferred drug for maintenance of anesthesia in this primate model.
Bauer
Andreas
A
Clinic for Anaesthesiology, Ludwig Maximilian University Munich, Munich, Germany. andreas.bauer@med.uni-muenchen.de
Baschnegger
Heiko
H
Renz
Vivian
V
Brandl
Ulrike
U
Brenner
Paolo
P
Thein
Eckart
E
Reichart
Bruno
B
Schmoeckel
Michael
M
Christ
Frank
F
D000768:Anesthesia, General / Q000379:methods / Q000662:veterinary; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002496:Central Venous Pressure / Q000187:drug effects; D004195:Disease Models, Animal; D006339:Heart Rate / Q000187:drug effects; D016027:Heart Transplantation / Q000379:methods*; D007530:Isoflurane / Q000494:pharmacology*; D008297:Male; D010215:Papio; D015742:Propofol / Q000494:pharmacology*; D034421:Sus scrofa; D014183:Transplantation, Heterologous / Q000379:methods*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D007530:Isoflurane; D015742:Propofol