Comparative Analysis of Ischemia-Reperfusion Injury in Heart Transplantation: A Single-Center Study Evaluating Conventional Ice-Cold Storage versus the Paragonix SherpaPak Cardiac Transport System

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-07-15 DOI:10.1111/ctr.15397

Dor Lotan, Cathrine M. Moeller, Afsana Rahman, Gal Rubinstein, Daniel Oren, Yonatan Mehlman, Andrea Fernandez Valledor, Ersilia M. DeFilippis, Jayant Raikhelkar, Kevin Clerkin, Justin Fried, David Majure, Yoshifumi Naka, Yuji Kaku, Koji Takeda, Kyung Taek Oh, Adil Yunis, Paolo C Colombo, Melana Yuzefpolskaya, Farhana Latif, Gabriel Sayer, Nir Uriel, Miroslav Sekulic

{"title":"Comparative Analysis of Ischemia-Reperfusion Injury in Heart Transplantation: A Single-Center Study Evaluating Conventional Ice-Cold Storage versus the Paragonix SherpaPak Cardiac Transport System","authors":"Dor Lotan, Cathrine M. Moeller, Afsana Rahman, Gal Rubinstein, Daniel Oren, Yonatan Mehlman, Andrea Fernandez Valledor, Ersilia M. DeFilippis, Jayant Raikhelkar, Kevin Clerkin, Justin Fried, David Majure, Yoshifumi Naka, Yuji Kaku, Koji Takeda, Kyung Taek Oh, Adil Yunis, Paolo C Colombo, Melana Yuzefpolskaya, Farhana Latif, Gabriel Sayer, Nir Uriel, Miroslav Sekulic","doi":"10.1111/ctr.15397","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Since the 2018 allocation system change in heart transplantation (HT), ischemic times have increased, which may be associated with peri-operative and post-operative complications. This study aimed to compare ischemia reperfusion injury (IRI) in hearts preserved using ice-cold storage (ICS) and the Paragonix SherpaPak TM Cardiac Transport System (CTS).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>From January 2021 to June 2022, consecutive endomyocardial biopsies from 90 HT recipients were analyzed by a cardiac pathologist in a single-blinded manner: 33 ICS and 57 CTS. Endomyocardial biopsies were performed at three-time intervals post-HT, and the severity of IRI manifesting histologically as coagulative myocyte necrosis (CMN) was evaluated, along with graft rejection and graft function.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The incidence of IRI at weeks 1, 4, and 8 post-HT were similar between the ICS and CTS groups. There was a 59.3% statistically significant reduction in CMN from week 1 to 4 with CTS, but not with ICS. By week 8, there were significant reductions in CMN in both groups. Only 1 out of 33 (3%) patients in the ICS group had an ischemic time >240 mins, compared to 10 out of 52 (19%) patients in the CTS group. During the follow-up period of 8 weeks to 12 months, there were no significant differences in rejection rates, formation of de novo donor-specific antibodies and overall survival between the groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The CTS preservation system had similar rates of IRI and clinical outcomes compared to ICS despite longer overall ischemic times. There is significantly more recovery of IRI in the early post operative period with CTS. This study supports CTS as a viable option for preservation from remote locations, expanding the donor pool.</p>\n </section>\n </div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.15397","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Since the 2018 allocation system change in heart transplantation (HT), ischemic times have increased, which may be associated with peri-operative and post-operative complications. This study aimed to compare ischemia reperfusion injury (IRI) in hearts preserved using ice-cold storage (ICS) and the Paragonix SherpaPak TM Cardiac Transport System (CTS).

Methods

From January 2021 to June 2022, consecutive endomyocardial biopsies from 90 HT recipients were analyzed by a cardiac pathologist in a single-blinded manner: 33 ICS and 57 CTS. Endomyocardial biopsies were performed at three-time intervals post-HT, and the severity of IRI manifesting histologically as coagulative myocyte necrosis (CMN) was evaluated, along with graft rejection and graft function.

Results

The incidence of IRI at weeks 1, 4, and 8 post-HT were similar between the ICS and CTS groups. There was a 59.3% statistically significant reduction in CMN from week 1 to 4 with CTS, but not with ICS. By week 8, there were significant reductions in CMN in both groups. Only 1 out of 33 (3%) patients in the ICS group had an ischemic time >240 mins, compared to 10 out of 52 (19%) patients in the CTS group. During the follow-up period of 8 weeks to 12 months, there were no significant differences in rejection rates, formation of de novo donor-specific antibodies and overall survival between the groups.

Conclusion

The CTS preservation system had similar rates of IRI and clinical outcomes compared to ICS despite longer overall ischemic times. There is significantly more recovery of IRI in the early post operative period with CTS. This study supports CTS as a viable option for preservation from remote locations, expanding the donor pool.

查看原文本刊更多论文

心脏移植中缺血再灌注损伤的比较分析：评估传统冰冷储存与 Paragonix SherpaPak 心脏转运系统的单中心研究。

背景：自 2018 年心脏移植（HT）分配制度改变以来，缺血时间增加，这可能与围手术期和术后并发症有关。本研究旨在比较使用冰冷储存（ICS）和Paragonix SherpaPak TM心脏运输系统（CTS）保存的心脏的缺血再灌注损伤（IRI）：从 2021 年 1 月到 2022 年 6 月，心脏病理学家以单盲方式分析了 90 例 HT 受体的连续心内膜活检组织：其中 33 例为 ICS，57 例为 CTS。心内膜活检在HT后的三次间隔期进行，评估组织学上表现为凝固性心肌细胞坏死（CMN）的IRI严重程度，以及移植物排斥反应和移植物功能：ICS组和CTS组在HT术后第1、4和8周的IRI发生率相似。从第 1 周到第 4 周，CTS 组的 CMN 有 59.3% 的统计学显著下降，而 ICS 组则没有。到第 8 周时，两组的 CMN 都有明显减少。在 33 名 ICS 组患者中，只有 1 人（3%）的缺血时间超过 240 分钟，而在 52 名 CTS 组患者中，有 10 人（19%）的缺血时间超过 240 分钟。在8周至12个月的随访期间，两组患者在排斥率、新的供体特异性抗体的形成和总体存活率方面没有明显差异：结论：尽管CTS保存系统的总体缺血时间更长，但其IRI发生率和临床结果与ICS相似。CTS术后早期的IRI恢复率明显更高。这项研究支持将 CTS 作为保存偏远地区器官的可行方案，从而扩大供体库。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.