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Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation

BACKGROUND: Perioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slus...

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Autores principales: Goerlich, Corbin E., Griffith, Bartley, Singh, Avneesh K., Abdullah, Mohamed, Singireddy, Shreya, Kolesnik, Irina, Lewis, Billeta, Sentz, Faith, Tatarov, Ivan, Hershfeld, Alena, Zhang, Tianshu, Strauss, Erik, Odonkor, Patrick, Williams, Brittney, Tabatabai, Ali, Bhutta, Adnan, Ayares, David, Kaczorowski, David J., Mohiuddin, Muhammad M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220198/
https://www.ncbi.nlm.nih.gov/pubmed/34177906
http://dx.doi.org/10.3389/fimmu.2021.667093
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author Goerlich, Corbin E.
Griffith, Bartley
Singh, Avneesh K.
Abdullah, Mohamed
Singireddy, Shreya
Kolesnik, Irina
Lewis, Billeta
Sentz, Faith
Tatarov, Ivan
Hershfeld, Alena
Zhang, Tianshu
Strauss, Erik
Odonkor, Patrick
Williams, Brittney
Tabatabai, Ali
Bhutta, Adnan
Ayares, David
Kaczorowski, David J.
Mohiuddin, Muhammad M.
author_facet Goerlich, Corbin E.
Griffith, Bartley
Singh, Avneesh K.
Abdullah, Mohamed
Singireddy, Shreya
Kolesnik, Irina
Lewis, Billeta
Sentz, Faith
Tatarov, Ivan
Hershfeld, Alena
Zhang, Tianshu
Strauss, Erik
Odonkor, Patrick
Williams, Brittney
Tabatabai, Ali
Bhutta, Adnan
Ayares, David
Kaczorowski, David J.
Mohiuddin, Muhammad M.
author_sort Goerlich, Corbin E.
collection PubMed
description BACKGROUND: Perioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush following crystalloid or blood-based cardioplegia versus continuous cold perfusion with XVIVO(©) heart solution (XHS) based cardioplegia. METHODS: Baboons were weight matched to genetically engineered swine heart donors. Cardioplegia volume was 30 cc/kg by donor weight, with del Nido cardioplegia and the addition of 25% by volume of donor whole blood. Continuous perfusion was performed using an XVIVO (©) Perfusion system with XHS to which baboon RBCs were added. RESULTS: PCXD was observed in 5/8 that were preserved with crystalloid cardioplegia followed by traditional cold, static storage on ice. By comparison, when blood cardioplegia was used followed by cold, static storage, PCXD occurred in 1/3 hearts and only in 1/5 hearts that were induced with XHS blood cardioplegia followed by continuous perfusion. Survival averaged 17 hours in those with traditional preservation and storage, followed by 11.47 days and 15.03 days using blood cardioplegia and XHS+continuous preservation, respectively. Traditional preservation resulted in more inotropic support and higher average peak serum lactate 14.3±1.7 mmol/L compared to blood cardioplegia 3.6±3.0 mmol/L and continuous perfusion 3.5±1.5 mmol/L. CONCLUSION: Blood cardioplegia induction, alone or followed by XHS perfusion storage, reduced the incidence of PCXD and improved graft function and survival, relative to traditional crystalloid cardioplegia-slush storage alone.
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spelling pubmed-82201982021-06-24 Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation Goerlich, Corbin E. Griffith, Bartley Singh, Avneesh K. Abdullah, Mohamed Singireddy, Shreya Kolesnik, Irina Lewis, Billeta Sentz, Faith Tatarov, Ivan Hershfeld, Alena Zhang, Tianshu Strauss, Erik Odonkor, Patrick Williams, Brittney Tabatabai, Ali Bhutta, Adnan Ayares, David Kaczorowski, David J. Mohiuddin, Muhammad M. Front Immunol Immunology BACKGROUND: Perioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush following crystalloid or blood-based cardioplegia versus continuous cold perfusion with XVIVO(©) heart solution (XHS) based cardioplegia. METHODS: Baboons were weight matched to genetically engineered swine heart donors. Cardioplegia volume was 30 cc/kg by donor weight, with del Nido cardioplegia and the addition of 25% by volume of donor whole blood. Continuous perfusion was performed using an XVIVO (©) Perfusion system with XHS to which baboon RBCs were added. RESULTS: PCXD was observed in 5/8 that were preserved with crystalloid cardioplegia followed by traditional cold, static storage on ice. By comparison, when blood cardioplegia was used followed by cold, static storage, PCXD occurred in 1/3 hearts and only in 1/5 hearts that were induced with XHS blood cardioplegia followed by continuous perfusion. Survival averaged 17 hours in those with traditional preservation and storage, followed by 11.47 days and 15.03 days using blood cardioplegia and XHS+continuous preservation, respectively. Traditional preservation resulted in more inotropic support and higher average peak serum lactate 14.3±1.7 mmol/L compared to blood cardioplegia 3.6±3.0 mmol/L and continuous perfusion 3.5±1.5 mmol/L. CONCLUSION: Blood cardioplegia induction, alone or followed by XHS perfusion storage, reduced the incidence of PCXD and improved graft function and survival, relative to traditional crystalloid cardioplegia-slush storage alone. Frontiers Media S.A. 2021-06-09 /pmc/articles/PMC8220198/ /pubmed/34177906 http://dx.doi.org/10.3389/fimmu.2021.667093 Text en Copyright © 2021 Goerlich, Griffith, Singh, Abdullah, Singireddy, Kolesnik, Lewis, Sentz, Tatarov, Hershfeld, Zhang, Strauss, Odonkor, Williams, Tabatabai, Bhutta, Ayares, Kaczorowski and Mohiuddin https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Goerlich, Corbin E.
Griffith, Bartley
Singh, Avneesh K.
Abdullah, Mohamed
Singireddy, Shreya
Kolesnik, Irina
Lewis, Billeta
Sentz, Faith
Tatarov, Ivan
Hershfeld, Alena
Zhang, Tianshu
Strauss, Erik
Odonkor, Patrick
Williams, Brittney
Tabatabai, Ali
Bhutta, Adnan
Ayares, David
Kaczorowski, David J.
Mohiuddin, Muhammad M.
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
title Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
title_full Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
title_fullStr Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
title_full_unstemmed Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
title_short Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
title_sort blood cardioplegia induction, perfusion storage and graft dysfunction in cardiac xenotransplantation
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220198/
https://www.ncbi.nlm.nih.gov/pubmed/34177906
http://dx.doi.org/10.3389/fimmu.2021.667093
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