title: Effect of hyperkalemia and hemolysis caused by hyperacute rejection on cardiac function in pig to human ex vivo xenogeneic cardiac perfusion model.
abstract: OBJECTIVE
  Hyperacute rejection (HAR) is a major obstacle to successful xenotransplantation of vascularized organs. This study was conducted to observe the effect of hemolysis of perfused human whole blood on pig heart function, and determine the major risk factors for preservation of xenoperfused cardiac function using ex-vivo pig to human xenogeneic cardiac perfusion model.
  
  
  METHODS
  Harvested pig hearts were perfused with normal human whole blood (group 1), two different types of pre-treated human whole blood (group 2: immunoglobulins were depleted by plasmapheresis, group 3: pre-treated with plasmapheresis, GAS914, cobra venom factor (CVF) and steroid), and normal porcine whole blood as control (group 4) for 3 hours.
  
  
  RESULTS
  Duration of heart beat was significantly prolonged in group 2 and group 3. Histological examination showed widespread HAR features but was gradually delayed in groups 2 and 3 compared to group 1. The absolute levels of serum creatine kinase-MB and Troponin I increased gradually, and was lower in group 3. Serum hemoglobin levels were rapidly increased in groups 3 and 4, compared to group 1. Extracellular potassium level increased sharply from the beginning of blood perfusion in groups 1, 2 and 3, compared to group 4.
  
  
  CONCLUSIONS
  Pretreatment of human whole blood, including immunoglobulin depletion, CVF and steroid reduced and delayed the destruction of pig myocardium by HAR. However, the increased extracellular potassium levels in groups 1, 2 and 3 reflected that these treatments could not prohibit myocardial injury by HAR.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University, Seoul, Korea.
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Hak-Mo
authors.initials: HM
authors.lastname: Lee
authors.forename: Byoung Chol
authors.initials: BC
authors.lastname: Oh
authors.forename: Hong-Gook
authors.initials: HG
authors.lastname: Lim
authors.forename: Jeong Ryul
authors.initials: JR
authors.lastname: Lee