Changes in left ventricular mechanical and hemodynamic function during acute rejection of orthotopically transplanted hearts in dogs

Stinson, Edward B.; Tecklenberg, Paul L.; Hollingsworth, Jefferson F.; Jones, Kent W.; Sloane, Robert; Rahmoeller, Glen

doi:10.1016/s0022-5223(19)41640-1

Cited by 37 publications

(5 citation statements)

References 8 publications

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“…In the present study, systolic dysfunction occurred only during severe rejection. Stinson et al [35] demonstrated in dogs that detectable deterioration of contractility at rest was a relatively late event during the course of rejection, suggesting myocardial necrosis as the major factor for decreased cardiac contractility. In addition to significant myocardial necrosis, changes in the ␤-adrenergic-adenyl cyclase system [36,37], a marked diminution of Ca 2ϩ sensitivity, and various cytokines may play a role in decreased contractility [38] during acute rejection.…”

Section: Severe Acute Rejectionmentioning

confidence: 99%

Systolic and Diastolic Properties and Myocardial Blood Flow in the Heterotopically Transplanted Rat Heart during Acute Cardiac Rejection

et al. 2001

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The aim of the study was to characterize the course of systolic and diastolic function, myocardial blood flow, and histologic changes during acute rejection in a model of heterotopic transplantation in rats. For this purpose isogenic Lewis-to-Lewis and allogenic DA (Dark Agouti)-to-Lewis rat cardiac transplants were studied 1 hour and 1, 3, and 5 days, respectively, after heterotopic intraabdominal transplantation. Myocardial tissue blood flow (MBF) was assessed by the hydrogen-clearance method. An implanted balloon was used to measure pressure-volume relations in the transplanted heart. Myocardial water content was determined at the end of the experiments, and histologic examinations were performed. The MBF recovered during the first day postoperatively in both groups and decreased again in the allogenic group after 3 and 5 days (p < 0.05); it remained stable in the isogenic group. Myocardial relaxation was already prolonged in the allogenic group after 3 days and deteriorated further. Left ventricular end-diastolic pressure progressively increased in the allogenic group, whereas it remained unchanged in the isogenic group up to 5 days. After recovery from ischemia, the left ventricular peak systolic pressure was stable in the isogenic group for the entire further observation period, but it significantly decreased in the allogenic group after 5 days (p < 0.05). Myocardial water content showed a significant increase in the allogenic group compared to that in the isogenic group after 5 days. In the allogenic group histologic examination confirmed mild to moderate rejection after 3 days and severe acute rejection after 5 days. Thus, after recovery from ischemia, mild to moderate cardiac rejection was associated with reduced MBF and impaired relaxation. In a typical sequence, generation of edema and impaired diastolic compliance were terminally followed by systolic dysfunction during severe rejection.

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Section: Severe Acute Rejectionmentioning

confidence: 99%

Systolic and Diastolic Properties and Myocardial Blood Flow in the Heterotopically Transplanted Rat Heart during Acute Cardiac Rejection

et al. 2001

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“…The histology and sequence of cardiac rejection are quite similar to what has been observed in the rejection of other organ allografts [7,20]; they consist of cellular infiltration and interstitial and intracellular edema followed by myocytolysis [21]. The physiologic expression of rejection consists of decreased compliance (an increased resistance to cardiac filling) and decreased cardiac contractility [22]:…”

Section: Diagnosis and Treatment Of Acute Rejectionmentioning

confidence: 66%

Current results of human heart transplantation

Dong

Shumway

1977

World j. surg.

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At Stanford University Medical Center 109 patients have received 114 heart transplants since 1968. The major indication for transplantation has been cardiac failure due to myopathy secondary to coronary arteriosclerosis. Idiopathic cardiomyopathy has been the second greatest indication. The immunosuppressive regimen has consisted of azathioprine, prednisone, and antithymocyte globulin. Overall, 1‐year survival is 52% and recent results indicate a 1‐year survival rate of 66%. Currently, 44 patients are alive and the longest surviving patient has enjoyed 6.5 post‐transplant years.

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“…Sustained laboratory and clinical research programme continued at a steady pace generating a continuous stream of new information leading to further refinement of recipient selection, donor management, immunosuppression, rejection surveillance or infection management [79]. The first experience of this new refinement was reported [337]. The indications or contraindications [120], and the criteria of donor hearts were defined [121].…”

Section: History Of Cardiac Transplantationmentioning

confidence: 99%

Cardiac retransplantation

Rzhanyi

Pechenenko²,

Alcocer³

et al. 2023

MMCTS

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An orthotopic heart transplant remains the gold standard treatment for patients with end-stage heart failure. Despite significant developments and the widespread use of durable mechanical circulation support, a small number of patients will be considered for a heart retransplant. In this video tutorial, we describe the strategy and technique for patients who have already received an orthotopic heart transplant and who undergo a cardiac retransplant with a modified bicaval anastomosis technique.

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Changes in left ventricular mechanical and hemodynamic function during acute rejection of orthotopically transplanted hearts in dogs

Cited by 37 publications

References 8 publications

Systolic and Diastolic Properties and Myocardial Blood Flow in the Heterotopically Transplanted Rat Heart during Acute Cardiac Rejection

Systolic and Diastolic Properties and Myocardial Blood Flow in the Heterotopically Transplanted Rat Heart during Acute Cardiac Rejection

Current results of human heart transplantation

Cardiac retransplantation

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