Coronary oxygen persufflation for heart preservation in pigs: analyses of endothelium and myocytes1

Abstract

The lack of structural defects related to the COP technique, similar endothelial function, and an even better metabolic state of the mHTK+COP hearts versus HTK 3h hearts demonstrate the efficacy of the COP technique for prolongation of myocardial preservation time up to 14 hr.

Comparing the ultrastructural effects of two different cardiac preparation- and perfusion-techniques in a porcine model of extracorporal long-term preservation

“…In general, our ultrastructural finding correspond well to KuhnRegnier et al [15], who described that a modified HTK solution improved endothelial function and metabolic state of the porcine hearts. The degree of protection of endothelial cells during reversible deep hypothermic ischemia depends on the method used for cardiac arrest and storage [5].…”

Persufflation (or gaseous oxygen perfusion) as a method of organ preservation

“…The authors noted that the transplant field is reluctant to adopt PSF as a legitimate cardiac preservation technique largely due to concerns about resulting endothelial damage. More recent studies have shown that the coronary arteries of porcine hearts following 3 hours of oxygen A-PSF had normal functioning endothelium post-transplant [14; 18; 34]. Additionally, hearts transplanted following 14 hours of A-PSF exhibited no topographic signs of endothelial damage, as assessed by scanning electron microscopy [34].…”

“…More recent studies have shown that the coronary arteries of porcine hearts following 3 hours of oxygen A-PSF had normal functioning endothelium post-transplant [14; 18; 34]. Additionally, hearts transplanted following 14 hours of A-PSF exhibited no topographic signs of endothelial damage, as assessed by scanning electron microscopy [34]. Fischer has recently reviewed work done by his group, and has described the detailed experimental approach in which A-PSF is recommended as the preferred method [16].…”

Use of continuous retrograde gaseous oxygen persufflation for myocardial protection during open heart surgery

“…However, several reports have demonstrated that no damage to endothelial cells was induced at the electron microscopic level and the physiological function of the endothelium is maintained in preserved hearts. [16][17][18][19][20] Considering cardiac function and ATP level during recovery, it seems unlikely that the GOP technique was indeed harmful. Future studies will determine whether there are morphological changes in the myocytes and endothelial cells following the use of the GOP technique.…”

“…This technique has been reported to be very effective for preserving organs for transplantation. [4][5][6][16][17][18][19][20] There are two approaches to GOP, namely antegrade and retrograde. The antegrade GOP technique using "aortic guard" was reported in the fi eld of heart preservation.…”