CARDIAC PRESERVATION PRIOR TO TRANSPLANTATION

点击翻译按钮获取中文摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Heart transplantation has become a life-saving treatment for end-stage cardiac disease. Its application is limited by the availability of donor hearts and the brief ischemic tolerance of preserved myocardium. Standard cold storage limits preservation intervals to 4 - 6 hours. Recent advances suggest perfusion preservation with oxygenated storage solution may extend the storage interval and permit utilization of marginal donor hearts. An inherent limitation of this technique when applied to long-term storage or use of suboptimal hearts is the difficulty in predicting post-transplant reperfusion function prior to implanting the organ. We previously utilized 1H magnetic resonance spectroscopy (MRS) of cardiac extracts to determine important metabolic differences between hearts preserved under static and perfused conditions. The tissue manipulation and time required to perform this analysis limit its clinical application. Magic angle spinning (MAS) MRS has been used to evaluate metabolism in intact tissue. We hypothesized that 1H MAS MRS could be used to rapidly determine the metabolic status of preserved myocardium. If successful, this would offer the potential to allow assessment of cardiac preservation success in a clinically relevant time interval. To test this possibility, we studied differences between standard static storage and perfusion storage in a large animal model of cardiac transplantation." metabolism.