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Superior myocardial preservation with HTK solution over Celsior in rat hearts with prolonged cold ischemia.

Authors
Lee, S; Huang, CS; Kawamura, T; Shigemura, N; Stolz, DB; Billiar, TR; Luketich, JD; Nakao, A; Toyoda, Y
Citation
Surgery, 148(2):463-473, 2010
Journal Title
Surgery
ISSN
0039-60601532-7361
Abstract
BACKGROUND: Increasing allograft ischemic time is a significant risk factor for mortality following heart transplantation (HTx). The purpose of this study was to evaluate the protective effects of histidine-tryptophan-ketoglutarate (HTK) and Celsior (CEL) using a rat HTx model with prolonged cold storage.



METHODS: The hearts were excised from donor rats, stored in cold preservation solution for either 6 or 18 hours, and heterotopically transplanted into syngeneic recipients. Serum creatine phosphokinase (CPK), serum troponin I, graft-infiltrating cells, graft mRNA levels for inflammatory mediators, and tissue adenosine triphosphate (ATP) levels were analyzed, as markers of graft injury.



RESULTS: The recipients of grafts stored in HTK for 18 hours of prolonged cold ischemia had lower levels of serum CPK and tissue malondialdehyde, less upregulation of the mRNAs for IL-6 and inducible nitric oxide synthase, less apoptosis, and higher ATP levels than those receiving grafts stored in CEL and Saline. Cardiac contraction 3 hours after reperfusion was observed in 43% of the cardiac grafts stored in HTK for 18 hours, while no cardiac wall movement was seen in grafts stored in either saline or CEL.



CONCLUSION: Cold storage in HTK exhibited superior protective effects against prolonged cold ischemia in a syngeneic rat transplantation model.
MeSH terms
AMP-Activated Protein Kinases/metabolismAdenosine Triphosphate/metabolismAnimalsApoptosisCold IschemiaCreatine Kinase/bloodDisaccharidesElectrolytesGlucoseGlutamatesGlutathioneHeart*Heart Transplantation*/pathologyHeart Transplantation*/physiologyHistidineInflammation Mediators/metabolismLipid PeroxidationMaleMannitolMicroscopy, Electron, TransmissionMyocardial ContractionMyocardial Reperfusion Injury/bloodMyocardial Reperfusion Injury/pathologyMyocardial Reperfusion Injury/physiopathologyMyocardial Reperfusion Injury/prevention & controlNeutrophils/pathologyOrgan Preservation/methods*Organ Preservation Solutions*Potassium ChlorideProcaineRNA, Messenger/geneticsRNA, Messenger/metabolismRatsRats, Inbred LewTroponin I/blood
DOI
10.1016/j.surg.2010.04.009
PMID
20627336
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Thoracic & Cardiovascular Surgery
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