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Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death

The impact of the machine perfusion of donation after circulatory death (DCD) hearts with the novel Custodiol-N solution on diastolic and coronary microvascular dysfunction is unknown. Porcine DCD-hearts were maintained four hours by perfusion with normothermic blood (DCD-B), hypothermic Custodiol (...

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Autores principales: Saemann, Lars, Georgevici, Adrian-Iustin, Hoorn, Fabio, Gharpure, Nitin, Veres, Gábor, Korkmaz-Icöz, Sevil, Karck, Matthias, Simm, Andreas, Wenzel, Folker, Szabó, Gábor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380662/
https://www.ncbi.nlm.nih.gov/pubmed/37511318
http://dx.doi.org/10.3390/ijms241411562
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author Saemann, Lars
Georgevici, Adrian-Iustin
Hoorn, Fabio
Gharpure, Nitin
Veres, Gábor
Korkmaz-Icöz, Sevil
Karck, Matthias
Simm, Andreas
Wenzel, Folker
Szabó, Gábor
author_facet Saemann, Lars
Georgevici, Adrian-Iustin
Hoorn, Fabio
Gharpure, Nitin
Veres, Gábor
Korkmaz-Icöz, Sevil
Karck, Matthias
Simm, Andreas
Wenzel, Folker
Szabó, Gábor
author_sort Saemann, Lars
collection PubMed
description The impact of the machine perfusion of donation after circulatory death (DCD) hearts with the novel Custodiol-N solution on diastolic and coronary microvascular dysfunction is unknown. Porcine DCD-hearts were maintained four hours by perfusion with normothermic blood (DCD-B), hypothermic Custodiol (DCD-C), or Custodiol-N (DCD-CN), followed by one hour of reperfusion with fresh blood, including microvascular and contractile evaluation. In another group (DCD group), one hour of reperfusion, including microvascular and contractile evaluation, was performed without a previous maintenance period (all groups N = 5). We measured diastolic function with a balloon catheter and microvascular perfusion by Laser-Doppler-Technology, resulting in Laser-Doppler-Perfusion (LDP). We performed immunohistochemical staining and gene expression analysis. The developed pressure was improved in DCD-C and DCD-CN. The diastolic pressure decrement (DCD-C: −1093 ± 97 mmHg/s; DCD-CN: −1703 ± 329 mmHg/s; DCD-B: −690 ± 97 mmHg/s; p < 0.05) and relative LDP (DCD-CN: 1.42 ± 0.12; DCD-C: 1.11 ± 0.13; DCD-B: 1.22 ± 0.27) were improved only in DCD-CN. In DCD-CN, the expression of eNOS increased, and ICAM and VCAM decreased. Only in DCD-B compared to DCD, the pathways involved in complement and coagulation cascades, focal adhesion, fluid shear stress, and the IL-6 and IL-17 pathways were upregulated. In conclusion, machine perfusion with Custodiol-N improves diastolic and microvascular function and preserves the microvascular endothelium of porcine DCD-hearts.
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spelling pubmed-103806622023-07-29 Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death Saemann, Lars Georgevici, Adrian-Iustin Hoorn, Fabio Gharpure, Nitin Veres, Gábor Korkmaz-Icöz, Sevil Karck, Matthias Simm, Andreas Wenzel, Folker Szabó, Gábor Int J Mol Sci Article The impact of the machine perfusion of donation after circulatory death (DCD) hearts with the novel Custodiol-N solution on diastolic and coronary microvascular dysfunction is unknown. Porcine DCD-hearts were maintained four hours by perfusion with normothermic blood (DCD-B), hypothermic Custodiol (DCD-C), or Custodiol-N (DCD-CN), followed by one hour of reperfusion with fresh blood, including microvascular and contractile evaluation. In another group (DCD group), one hour of reperfusion, including microvascular and contractile evaluation, was performed without a previous maintenance period (all groups N = 5). We measured diastolic function with a balloon catheter and microvascular perfusion by Laser-Doppler-Technology, resulting in Laser-Doppler-Perfusion (LDP). We performed immunohistochemical staining and gene expression analysis. The developed pressure was improved in DCD-C and DCD-CN. The diastolic pressure decrement (DCD-C: −1093 ± 97 mmHg/s; DCD-CN: −1703 ± 329 mmHg/s; DCD-B: −690 ± 97 mmHg/s; p < 0.05) and relative LDP (DCD-CN: 1.42 ± 0.12; DCD-C: 1.11 ± 0.13; DCD-B: 1.22 ± 0.27) were improved only in DCD-CN. In DCD-CN, the expression of eNOS increased, and ICAM and VCAM decreased. Only in DCD-B compared to DCD, the pathways involved in complement and coagulation cascades, focal adhesion, fluid shear stress, and the IL-6 and IL-17 pathways were upregulated. In conclusion, machine perfusion with Custodiol-N improves diastolic and microvascular function and preserves the microvascular endothelium of porcine DCD-hearts. MDPI 2023-07-17 /pmc/articles/PMC10380662/ /pubmed/37511318 http://dx.doi.org/10.3390/ijms241411562 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Saemann, Lars
Georgevici, Adrian-Iustin
Hoorn, Fabio
Gharpure, Nitin
Veres, Gábor
Korkmaz-Icöz, Sevil
Karck, Matthias
Simm, Andreas
Wenzel, Folker
Szabó, Gábor
Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death
title Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death
title_full Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death
title_fullStr Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death
title_full_unstemmed Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death
title_short Improving Diastolic and Microvascular Function in Heart Transplantation with Donation after Circulatory Death
title_sort improving diastolic and microvascular function in heart transplantation with donation after circulatory death
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380662/
https://www.ncbi.nlm.nih.gov/pubmed/37511318
http://dx.doi.org/10.3390/ijms241411562
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