hDAF porcine cardiac xenograft maintains cardiac output after orthotopic transplantation into baboon - a perioperative study
hDAF porcine cardiac xenograft maintains cardiac output after orthotopic transplantation into baboon - a perioperative study
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DOI：
10.1111/j.1399-3089.2005.00242.x
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发表时间：
2005-11-01
影响因子：
3.9
通讯作者：
Christ, F
中科院分区：
文献类型：
--
作者：
Bauer, A;Baschnegger, H;Christ, F
背景：关于原位猪狒狒移植（oXHTx）后心脏异种移植物的生理功能相容性的数据有限。因此，我们研究了 oXHTx 前后的血流动力学参数，包括心输出量 (CO)。 方法：对 9 只 hDAF 转基因仔猪进行原位异种心脏移植至狒狒。我们使用股动脉热稀释法对 CO 和每搏输出量进行侵入性评估。结果：麻醉诱导后狒狒的基线 CO 为 1.36 (1.0-1.9) 1/min。体外循环终止后30～60 min，心脏异种移植物的CO显着增加至1.72(1.3-2.1) 1/min(P<0.01)。移植前狒狒心脏和心脏异种移植物的每搏输出量相当[14.9 (11-26) vs. 11.8 (10-23) ml]。因此，oXHTx 后心率增加可实现更高的 CO [75.0 (69-110) vs. 140.0 (77-180)/min； P<0.01]。尽管 CO 增加，但氧气输送量却减少了 [256 (251-354) vs. 227 (172-477) ml/min； P < 0.01]由于体外循环过程中不可避免的血液稀释和手术过程引起的失血。结论：我们的结果表明，在hDAF猪心脏原位移植给狒狒后的早期阶段，供体心脏的心脏功能得以维持并超过基线CO。然而，在术中早期阶段，由于不可避免的失血和旁路回路启动引起的稀释，这只能通过使用正性肌力物质和血管加压药来实现。
Background: Only limited data are available on the physiological functional compatibility of cardiac xenografts after orthotopic pig to baboon transplantation (oXHTx). Thus we investigated hemodynamic parameters including cardiac output (CO) before and after oXHTx.Methods: Orthotopic xenogeneic heart transplantation from nine hDAF transgeneic piglets to baboons was performed. We used femoral arterial thermodilution for the invasive assessment of CO and stroke volume. Results: Baseline CO of the baboons after induction of anesthesia was 1.36 (1.0-1.9) 1/min. 30 to 60 min after termination of the cardiopulmonary bypass, CO of the cardiac xenograft was significantly increased to 1.72 (1.3-2.1) 1/min (P < 0.01). The stroke volumes of the baboon heart before transplantation and the cardiac xenograft was comparable [14.9 (11-26) vs. 11.8 (10-23) ml]. Thus the higher CO was achieved by an increase in heart rate after oXHTx [75.0 (69-110) vs. 140.0 (77-180)/ min; P < 0.01]. Despite the increased CO, oxygen delivery was reduced [256 (251-354) vs. 227 (172-477) ml/min; P < 0.01] due to the inevitable hemodilution during the cardiopulmonary bypass and the blood loss caused by the surgical procedures.Conclusion: Our results demonstrate that in the early phase after orthotopic transplantation of hDAF pig hearts to baboons, cardiac function of the donor heart is maintained and exceeds baseline CO. However, in the early intraoperative phase this was only possible by using inotropic substances and vasopressors due to the inevitable blood loss and dilution by the priming of the bypass circuit.