Orthotopic Heart Auto-Transplantation in a Swine Model.
Orthotopic Heart Auto-Transplantation in a Swine Model.
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DOI：
10.4236/wjcs.2022.129017
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发表时间：
2022-09
期刊：
影响因子：
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通讯作者：
Lozonschi L
中科院分区：
文献类型：
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作者：
Rogers MP;Fishberger G;Martini N;Baldwin M;Wang L;Chen W;Liu R;Lozonschi L
背景和目的：猪心脏与人类心脏最相似，并且仍然是解剖学、生理学和医疗器械研究的首选临床前模型。为了研究与缺血再灌注和供体保存方案严格相关的现象，必须避免与同种异体移植相关的免疫反应。原位自体移植是心脏移植领域离体实验的一种独特策略。然而，自体移植本身也存在技术挑战，即需要横切和重新吻合的大血管长度不足。方法：开发并描述了一种在猪模型中进行原位心脏自体移植的新方法。使用猪模型对一种新装置进行离体实验，以研究缺血再灌注损伤。结果：总共使用五个猪模型对一种新型装置进行离体实验，以减轻缺血再灌注损伤并确定供体保存的效果。描述了对常规心脏移植方案的修改，以实现成功的自体移植。结论：猪模型原位自体心脏移植是可靠研究缺血再灌注损伤和供体保存方案的一种合理且技术上可行的方法。在这里，我们描述了直接原位猪心脏自体移植的方法以及可以替代完整手术自体移植的简化方案，用于保存供体心脏的研究。
Background and Aim: The porcine heart bears the best resemblance to the human heart and remains the preferred preclinical model for anatomical, physiological, and medical device studies. In an effort to study phenomena related strictly to ischemia reperfusion and donor preservation protocols, it is essential to avoid the immune responses related to allotransplantation. Orthotopic auto-transplantation is a unique strategy to the field of cardiac transplantation for ex vivo experimentation. Nevertheless, auto-transplantation carries its own technical challenges related to insufficient length of the great vessels that are to be transected and re-anastomosed. Methods: A novel method for orthotopic cardiac auto-transplantation in the porcine model was developed and was described herein. Porcine models were used for ex vivo experimentation of a novel device to study ischemia reperfusion injury. Results: A total of five porcine models were used for ex vivo experimentation of a novel device to mitigate ischemia reperfusion injury and determine effects of donor preservation. Modifications to routine cardiac transplantation protocols to allow for successful auto-transplantation are described. Conclusion: Orthotopic cardiac auto-transplantation in the porcine model is a plausible and technically feasible method for reliable study of ischemia reperfusion injury and donor preservation protocols. Here, we describe methods for both direct orthotopic porcine cardiac auto-transplantations as well as a simplified protocol that can be substituted for full surgical auto-transplantation for the studies of preservation of donor hearts.