- Author: Mukhammad Kayumov, Kyo Seon Lee, Dowan Kim, Wangin Kim, Reverien Habimana, Jiae Seong, Hwa Jin Cho, In-Seok Jeong
- Date: 2025/02/01
- Journal: Journal of Surgical Research;306;437-448
- PMID: 39862726
- PMCID:
- DOI: https://doi.org/10.1016/j.jss.2024.12.050
Abstract
Introduction: Cold static storage (CSS) and normothermic ex-situ preservation are the most widely used donor heart preservation techniques worldwide. The current study compares both CSS and normothermic ex-situ preservation methods in terms of graft performance, morphologic changes, and acute immune response in an experimental model.
Method and materials: Twenty rats underwent heterotopic abdominal heart transplantation after 2 h of CSS (group 1; n = 10) or normothermic ex-situ perfusion (group 2; n = 10). Blood samples were obtained from recipients just before and after 4 h of transplantation to analyze surface markers of immune cells and cytokines. Electrocardiography and echocardiography were performed before donor heart harvesting and after heterotopic transplantation. After 4 h of transplantation, donor hearts were extracted for further histologic studies.
Results: All recipient animals in both groups successfully survived after heterotopic transplantation. The mean ischemic time of the donor heart was 163 ± 8.34 mins in group 1 and 43.8 ± 6.97 mins in group 2 (P < 0.01). Ejection fraction significantly decreased after transplantation in both groups but were less significant in group 2 (the mean difference group 1: -34.3 ± 3.54, P < 0.01; group 2: -14.3 ± 15.47, P = 0.01). The percentage of granulocyte significantly increased in both group 1 and group 2, but the significance was more pronounced in group 1 (the mean difference group 1: 48.7 ± 5.36, P < 0.01; group 2: 39.7 ± 13.1, P < 0.01).
Conclusions: Normothermic ex-situ perfusion is associated with well-preserved donor hearts but a similar recipient acute immune response in comparison with CSS in the rat model.
Keywords: Cold static storage; Donor heart preservation; Heterotopic heart transplantation; Normothermic machine perfusion; Small animal model.