Long-term normothermic autoperfusion of the cardiopulmonary complex ex vivo as a method of effective graft conditioning: an experimental study

Q4 Medicine

Patologiya krovoobrashcheniya i kardiokhirurgiya Pub Date : 2023-12-26 DOI:10.21688/1681-3472-2023-4-33-42

M. Zhulkov, A. Tarkova, I. Zykov, A. G. Makaev, A. Protopopov, M. Murtazaliev, F. Kosimov, N. A. Karmadonova, Ya. M. Smirnov, E. Kliver, A. M. Volkov, H. Agaeva, D. Sirota

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Abstract

Objective: To compare the effectiveness of 6-hour normothermic autoperfusion of a heart graft ex vivo with pharmaco-cold preservation using Bretschneider's solution (Custodiol, Dr Franz Köhler Chemie GmbH, Bensheim, Germany).Methods: Landrace pigs weighing 50 ± 5 kg and aged 4–5 months (n = 10) were selected as a model for a series of acute experiments. Cardiopulmonary conditioning using autoperfusion was conducted for 6 hours on the experimental group (n = 5). On the other hand, the control group underwent a 6-hour pharmaco-cold preservation with Bretschneider solution to recover the heart's pumping function. Graft preservation effectiveness was evaluated by measuring hemodynamic parameters, heartbeat, and myocardial ischemia marker concentrations.Results: After reperfusion and isolation of the working cardiopulmonary complex, cardiac output was 0.63 [0.37; 0.8] L/min and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (P < .05). The levels of CPK-MB, LDH, troponin-I, and lactate in the coronary sinus blood was significantly higher in the control group.Conclusion: The study demonstrated significant benefits of normothermic autoperfusion in maintaining the morphofunctional status of the donor heart compared to pharmaco-cold preservation using Bretschneider's solution for 6 hours of ex vivo graft conditioning. Received 16 July 2023. Revised 8 September 2023. Accepted 11 September 2023. Funding: The study was carried out within the framework of project No. 23-25-10013 (agreement No. 23-25-10013 dated April 20, 2023 with the Russian Science Foundation, agreement No. р-52 dated April 3, 2023 with the Ministry of Science and Innovation Policy of the Novosibirsk Region). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, I.S. ZykovData collection and analysis: M.O. Zhulkov, A.R. Tarkova, I.S. Zykov, A.G. Makaev, A.V. Protopopov, M.N. Murtazaliev, F.Yu. Kosimov, N.A. Karmadonova, Ya.M. Smirnov, E.E. Kliver, A.M. Volkov, H.A. Agaeva, D.A. SirotaStatistical analysis: M.O. ZhulkovDrafting the article: M.O. ZhulkovCritical revision of the article: M.O. Zhulkov, D.A. Sirota, I.S. ZykovFinal approval of the version to be published: M.O. Zhulkov, A.R. Tarkova, I.S. Zykov, A.G. Makaev, A.V. Protopopov, M.N. Murtazaliev, F.Yu. Kosimov, N.A. Karmadonova, Ya.M. Smirnov, E.E. Kliver, A.M. Volkov, H.A. Agaeva, D.A. Sirota

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作为有效移植物调节方法的心肺复合体体外长期常温自灌注：一项实验研究

目的比较体内心脏移植物 6 小时常温自体灌注与使用 Bretschneider 溶液（Custodiol，Dr Franz Köhler Chemie GmbH，德国本斯海姆）进行药冷保存的效果：方法：选择体重为 50 ± 5 千克、年龄为 4-5 个月大（n = 10）的陆地猪作为一系列急性实验的模型。对实验组（5 头）进行 6 小时的自灌注心肺调节。另一方面，对照组使用布氏溶液进行 6 小时药冷保存，以恢复心脏的泵血功能。通过测量血流动力学参数、心跳和心肌缺血标志物浓度来评估移植物保存效果：结果：再灌注和分离工作心肺复合体后，实验组和对照组的心输出量分别为 0.63 [0.37; 0.8] L/min 和 0.37 [0.23; 0.37] L/min（P < .05）。对照组冠状动脉窦血中 CPK-MB、LDH、肌钙蛋白-I 和乳酸的水平明显更高：结论：该研究表明，与使用布氏溶液进行 6 小时体外移植物调理的药冷保存相比，常温自体灌注在维持供体心脏形态功能状态方面具有明显优势。2023年7月16日收到。2023年9月8日修订。2023年9月11日接受。资助：本研究在第 23-25-10013 号项目框架内进行（2023 年 4 月 20 日与俄罗斯科学基金会签订的第 23-25-10013 号协议，2023 年 4 月 3 日与新西伯利亚州科学与创新政策部签订的第р-52 号协议）。利益冲突：作者声明无利益冲突。作者的贡献构思和研究设计：M.O. Zhulkov, D.A. Sirota, I.S. Zykov数据收集和分析：M.O. Zhulkov, D.A. Sirota, I.S. ZykovM.O. Zhulkov、A.R. Tarkova、I.S. Zykov、A.G. Makaev、A.V. Protopopov、M.N. Murtazaliev、F.Yu.Kosimov、N.A. Karmadonova、Ya.M. Smirnov、E.E. Kliver、A.M. Volkov、H.A. Agaeva、D.A. Sirota统计分析：M.O. Zhulkov起草文章：M.O. ZhulkovCritical revision of the article：M.O. Zhulkov、D.A. Sirota、I.S. Zykov最终批准出版版本：M.O. Zhulkov、A.R. Tarkova、I.S. Zykov、A.G. Makaev、A.V. Protopopov、M.N. Murtazaliev、F.Yu.Kosimov、N.A. Karmadonova、Ya.M. Smirnov、E.E. Kliver、A.M. Volkov、H.A. Agaeva、D.A. Sirota

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