Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation.
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation.
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DOI：
10.3389/fimmu.2021.667093
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发表时间：
2021
影响因子：
7.3
通讯作者：
Mohiuddin MM
中科院分区：
文献类型：
--
作者：
Goerlich CE;Griffith B;Singh AK;Abdullah M;Singireddy S;Kolesnik I;Lewis B;Sentz F;Tatarov I;Hershfeld A;Zhang T;Strauss E;Odonkor P;Williams B;Tabatabai A;Bhutta A;Ayares D;Kaczorowski DJ;Mohiuddin MM
围手术期心脏异种移植功能障碍（PCXD）描述异种移植后迅速发展的心功能丧失。尽管基因修饰增加了心脏的相容性，但PCXD仍会发生。我们报告了晶体或血液心脏骤停后在冰泥中静态保存与XVIVO©心脏溶液（XHS）心脏骤停后连续冷灌注的PCXD的发生率。狒狒的体重与基因工程猪心脏捐赠者相匹配。心脏骤停体积按供者体重计为30 cc/kg， del Nido心脏骤停，加入供者全血体积计25%。使用XVIVO©灌注系统进行连续灌注，XHS加入狒狒红细胞。结晶性心脏截留法保存后，传统冷冻、静态冰敷法保存后，5/8观察到PCXD。相比之下，用血停搏后冷、静贮存时，1/3的心脏发生了PCXD，而用XHS血停搏后持续灌注的心脏只有1/5发生了PCXD。传统保存保存组平均存活时间为17 h，血停搏和XHS+连续保存组平均存活时间分别为11.47 d和15.03 d。与血停搏3.6±3.0 mmol/L和连续灌注3.5±1.5 mmol/L相比，传统保存能获得更多的肌力支持，血清乳酸平均峰值（14.3±1.7 mmol/L）更高。与传统的晶体心脏骤停-浆液单独储存相比，单独或随后进行XHS灌注储存的血液心脏骤停诱导可降低PCXD的发生率，提高移植物功能和存活率。
Perioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush following crystalloid or blood-based cardioplegia versus continuous cold perfusion with XVIVO© heart solution (XHS) based cardioplegia. Baboons were weight matched to genetically engineered swine heart donors. Cardioplegia volume was 30 cc/kg by donor weight, with del Nido cardioplegia and the addition of 25% by volume of donor whole blood. Continuous perfusion was performed using an XVIVO © Perfusion system with XHS to which baboon RBCs were added. PCXD was observed in 5/8 that were preserved with crystalloid cardioplegia followed by traditional cold, static storage on ice. By comparison, when blood cardioplegia was used followed by cold, static storage, PCXD occurred in 1/3 hearts and only in 1/5 hearts that were induced with XHS blood cardioplegia followed by continuous perfusion. Survival averaged 17 hours in those with traditional preservation and storage, followed by 11.47 days and 15.03 days using blood cardioplegia and XHS+continuous preservation, respectively. Traditional preservation resulted in more inotropic support and higher average peak serum lactate 14.3±1.7 mmol/L compared to blood cardioplegia 3.6±3.0 mmol/L and continuous perfusion 3.5±1.5 mmol/L. Blood cardioplegia induction, alone or followed by XHS perfusion storage, reduced the incidence of PCXD and improved graft function and survival, relative to traditional crystalloid cardioplegia-slush storage alone.
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DOI：
10.1016/j.ijsu.2015.08.038
发表时间：
2015-11
期刊：
International journal of surgery (London, England)
影响因子：
--
作者：
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通讯作者：
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影响因子：
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