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Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times

INTRODUCTION: Cryopreserved allograft heart valves (CAHV) show longer event-free survival compared to other types of protheses. However, all patients develop early and/or late allograft failure. Negative predictors are clinical, and there is a lack of evidence whether they correspond with the micros...

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Autores principales: Fabian, Ondrej, Havova, Mariia, Gebauer, Roman, Poruban, Rudolf, Spatenka, Jaroslav, Burkert, Jan, Rohn, Vilem, Chaloupecky, Vaclav, Komarek, Arnost, Kala, Tomas, Janousek, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670335/
https://www.ncbi.nlm.nih.gov/pubmed/35072402
http://dx.doi.org/10.21470/1678-9741-2020-0710
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author Fabian, Ondrej
Havova, Mariia
Gebauer, Roman
Poruban, Rudolf
Spatenka, Jaroslav
Burkert, Jan
Rohn, Vilem
Chaloupecky, Vaclav
Komarek, Arnost
Kala, Tomas
Janousek, Jan
author_facet Fabian, Ondrej
Havova, Mariia
Gebauer, Roman
Poruban, Rudolf
Spatenka, Jaroslav
Burkert, Jan
Rohn, Vilem
Chaloupecky, Vaclav
Komarek, Arnost
Kala, Tomas
Janousek, Jan
author_sort Fabian, Ondrej
collection PubMed
description INTRODUCTION: Cryopreserved allograft heart valves (CAHV) show longer event-free survival compared to other types of protheses. However, all patients develop early and/or late allograft failure. Negative predictors are clinical, and there is a lack of evidence whether they correspond with the microscopic structure of CAHV. We assessed histopathological signs of structural degeneration, degree of cellular preservation, and presence of antigen-presenting cells (APC) in CAHV and correlated the changes with donor clinical characteristics, cryopreservation times, and CAHV types and diameters. METHODS: Fifty-seven CAHV (48 pulmonary, nine aortic) used for transplantation between November/2017 and May/2019 were included. Donor variables were age, gender, blood group, height, weight, and body surface area (BSA). Types and diameters of CAHV, cold ischemia time, period from decontamination to cryopreservation, and cryopreservation time were recorded. During surgery, arterial wall (n=56) and valvar cusp (n=20) samples were obtained from the CAHV and subjected to microscopy. Microscopic structure was assessed using basic staining methods and immunohistochemistry (IHC). RESULTS: Most of the samples showed signs of degeneration, usually of mild degree, and markedly reduced cellular preservation, more pronounced in aortic CAHV, correlating with arterial APC counts in both basic staining and IHC. There was also a correlation between the degree of degeneration of arterial samples and age, height, weight, and BSA of the donors. These findings were independent of preservation times. CONCLUSION: CAHV show markedly reduced cellular preservation negatively correlating with the numbers of APC. More preserved CAHV may be therefore prone to stronger immune rejection.
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spelling pubmed-96703352022-11-21 Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times Fabian, Ondrej Havova, Mariia Gebauer, Roman Poruban, Rudolf Spatenka, Jaroslav Burkert, Jan Rohn, Vilem Chaloupecky, Vaclav Komarek, Arnost Kala, Tomas Janousek, Jan Braz J Cardiovasc Surg Original Article INTRODUCTION: Cryopreserved allograft heart valves (CAHV) show longer event-free survival compared to other types of protheses. However, all patients develop early and/or late allograft failure. Negative predictors are clinical, and there is a lack of evidence whether they correspond with the microscopic structure of CAHV. We assessed histopathological signs of structural degeneration, degree of cellular preservation, and presence of antigen-presenting cells (APC) in CAHV and correlated the changes with donor clinical characteristics, cryopreservation times, and CAHV types and diameters. METHODS: Fifty-seven CAHV (48 pulmonary, nine aortic) used for transplantation between November/2017 and May/2019 were included. Donor variables were age, gender, blood group, height, weight, and body surface area (BSA). Types and diameters of CAHV, cold ischemia time, period from decontamination to cryopreservation, and cryopreservation time were recorded. During surgery, arterial wall (n=56) and valvar cusp (n=20) samples were obtained from the CAHV and subjected to microscopy. Microscopic structure was assessed using basic staining methods and immunohistochemistry (IHC). RESULTS: Most of the samples showed signs of degeneration, usually of mild degree, and markedly reduced cellular preservation, more pronounced in aortic CAHV, correlating with arterial APC counts in both basic staining and IHC. There was also a correlation between the degree of degeneration of arterial samples and age, height, weight, and BSA of the donors. These findings were independent of preservation times. CONCLUSION: CAHV show markedly reduced cellular preservation negatively correlating with the numbers of APC. More preserved CAHV may be therefore prone to stronger immune rejection. Sociedade Brasileira de Cirurgia Cardiovascular 2022 /pmc/articles/PMC9670335/ /pubmed/35072402 http://dx.doi.org/10.21470/1678-9741-2020-0710 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Fabian, Ondrej
Havova, Mariia
Gebauer, Roman
Poruban, Rudolf
Spatenka, Jaroslav
Burkert, Jan
Rohn, Vilem
Chaloupecky, Vaclav
Komarek, Arnost
Kala, Tomas
Janousek, Jan
Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times
title Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times
title_full Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times
title_fullStr Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times
title_full_unstemmed Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times
title_short Structural Integrity and Cellular Viability of Cryopreserved Allograft Heart Valves in Right Ventricular Outflow Tract Reconstruction: Correlation of Histopathological Changes with Donor Characteristics and Preservation Times
title_sort structural integrity and cellular viability of cryopreserved allograft heart valves in right ventricular outflow tract reconstruction: correlation of histopathological changes with donor characteristics and preservation times
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670335/
https://www.ncbi.nlm.nih.gov/pubmed/35072402
http://dx.doi.org/10.21470/1678-9741-2020-0710
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