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Critical warm ischemia time point for cardiac donation after circulatory death

Donation after circulatory death (DCD) represents a promising opportunity to overcome the relative shortage of donors for heart transplantation. However, the necessary period of warm ischemia is a concern. This study aims to determine the critical warm ischemia time based on in vivo biochemical chan...

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Autores principales: Sánchez‐Cámara, Silvia, Asensio‐López, Mari C., Royo‐Villanova, Mario, Soler, Fernando, Jara‐Rubio, Rubén, Garrido‐Peñalver, Jose Francisco, Pinar, Eduardo, Hernández‐Vicente, Álvaro, Hurtado, Jose Antonio, Lax, Antonio, Pascual‐Figal, Domingo A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303247/
https://www.ncbi.nlm.nih.gov/pubmed/35114047
http://dx.doi.org/10.1111/ajt.16987
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author Sánchez‐Cámara, Silvia
Asensio‐López, Mari C.
Royo‐Villanova, Mario
Soler, Fernando
Jara‐Rubio, Rubén
Garrido‐Peñalver, Jose Francisco
Pinar, Eduardo
Hernández‐Vicente, Álvaro
Hurtado, Jose Antonio
Lax, Antonio
Pascual‐Figal, Domingo A.
author_facet Sánchez‐Cámara, Silvia
Asensio‐López, Mari C.
Royo‐Villanova, Mario
Soler, Fernando
Jara‐Rubio, Rubén
Garrido‐Peñalver, Jose Francisco
Pinar, Eduardo
Hernández‐Vicente, Álvaro
Hurtado, Jose Antonio
Lax, Antonio
Pascual‐Figal, Domingo A.
author_sort Sánchez‐Cámara, Silvia
collection PubMed
description Donation after circulatory death (DCD) represents a promising opportunity to overcome the relative shortage of donors for heart transplantation. However, the necessary period of warm ischemia is a concern. This study aims to determine the critical warm ischemia time based on in vivo biochemical changes. Sixteen DCD non‐cardiac donors, without cardiovascular disease, underwent serial endomyocardial biopsies immediately before withdrawal of life‐sustaining therapy (WLST), at circulatory arrest (CA) and every 2 min thereafter. Samples were processed into representative pools to assess calcium homeostasis, mitochondrial function and cellular viability. Compared to baseline, no significant deterioration was observed in any studied parameter at the time of CA (median: 9 min; IQR: 7–13 min; range: 4–19 min). Ten min after CA, phosphorylation of cAMP‐dependent protein kinase‐A on Thr197 and SERCA2 decreased markedly; and parallelly, mitochondrial complex II and IV activities decreased, and caspase 3/7 activity raised significantly. These results did not differ when donors with higher WLST to CA times (≥9 min) were analyzed separately. In human cardiomyocytes, the period from WLST to CA and the first 10 min after CA were not associated with a significant compromise in cellular function or viability. These findings may help to incorporate DCD into heart transplant programs.[Image: see text]
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spelling pubmed-93032472022-07-22 Critical warm ischemia time point for cardiac donation after circulatory death Sánchez‐Cámara, Silvia Asensio‐López, Mari C. Royo‐Villanova, Mario Soler, Fernando Jara‐Rubio, Rubén Garrido‐Peñalver, Jose Francisco Pinar, Eduardo Hernández‐Vicente, Álvaro Hurtado, Jose Antonio Lax, Antonio Pascual‐Figal, Domingo A. Am J Transplant ORIGINAL ARTICLES Donation after circulatory death (DCD) represents a promising opportunity to overcome the relative shortage of donors for heart transplantation. However, the necessary period of warm ischemia is a concern. This study aims to determine the critical warm ischemia time based on in vivo biochemical changes. Sixteen DCD non‐cardiac donors, without cardiovascular disease, underwent serial endomyocardial biopsies immediately before withdrawal of life‐sustaining therapy (WLST), at circulatory arrest (CA) and every 2 min thereafter. Samples were processed into representative pools to assess calcium homeostasis, mitochondrial function and cellular viability. Compared to baseline, no significant deterioration was observed in any studied parameter at the time of CA (median: 9 min; IQR: 7–13 min; range: 4–19 min). Ten min after CA, phosphorylation of cAMP‐dependent protein kinase‐A on Thr197 and SERCA2 decreased markedly; and parallelly, mitochondrial complex II and IV activities decreased, and caspase 3/7 activity raised significantly. These results did not differ when donors with higher WLST to CA times (≥9 min) were analyzed separately. In human cardiomyocytes, the period from WLST to CA and the first 10 min after CA were not associated with a significant compromise in cellular function or viability. These findings may help to incorporate DCD into heart transplant programs.[Image: see text] John Wiley and Sons Inc. 2022-02-21 2022-05 /pmc/articles/PMC9303247/ /pubmed/35114047 http://dx.doi.org/10.1111/ajt.16987 Text en © 2022 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle ORIGINAL ARTICLES
Sánchez‐Cámara, Silvia
Asensio‐López, Mari C.
Royo‐Villanova, Mario
Soler, Fernando
Jara‐Rubio, Rubén
Garrido‐Peñalver, Jose Francisco
Pinar, Eduardo
Hernández‐Vicente, Álvaro
Hurtado, Jose Antonio
Lax, Antonio
Pascual‐Figal, Domingo A.
Critical warm ischemia time point for cardiac donation after circulatory death
title Critical warm ischemia time point for cardiac donation after circulatory death
title_full Critical warm ischemia time point for cardiac donation after circulatory death
title_fullStr Critical warm ischemia time point for cardiac donation after circulatory death
title_full_unstemmed Critical warm ischemia time point for cardiac donation after circulatory death
title_short Critical warm ischemia time point for cardiac donation after circulatory death
title_sort critical warm ischemia time point for cardiac donation after circulatory death
topic ORIGINAL ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303247/
https://www.ncbi.nlm.nih.gov/pubmed/35114047
http://dx.doi.org/10.1111/ajt.16987
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