Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
BackgroundPerioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush...
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Frontiers Media S.A.
2021-06-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2021.667093/full |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Corbin E. Goerlich Corbin E. Goerlich Bartley Griffith Avneesh K. Singh Mohamed Abdullah Mohamed Abdullah Shreya Singireddy Irina Kolesnik Billeta Lewis Faith Sentz Ivan Tatarov Alena Hershfeld Tianshu Zhang Erik Strauss Patrick Odonkor Brittney Williams Ali Tabatabai Adnan Bhutta David Ayares David J. Kaczorowski Muhammad M. Mohiuddin |
spellingShingle |
Corbin E. Goerlich Corbin E. Goerlich Bartley Griffith Avneesh K. Singh Mohamed Abdullah Mohamed Abdullah Shreya Singireddy Irina Kolesnik Billeta Lewis Faith Sentz Ivan Tatarov Alena Hershfeld Tianshu Zhang Erik Strauss Patrick Odonkor Brittney Williams Ali Tabatabai Adnan Bhutta David Ayares David J. Kaczorowski Muhammad M. Mohiuddin Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation Frontiers in Immunology xenotransplantation graft dysfunction cardiac xenotransplantation cardiac preservation heart transplant heart failure |
author_facet |
Corbin E. Goerlich Corbin E. Goerlich Bartley Griffith Avneesh K. Singh Mohamed Abdullah Mohamed Abdullah Shreya Singireddy Irina Kolesnik Billeta Lewis Faith Sentz Ivan Tatarov Alena Hershfeld Tianshu Zhang Erik Strauss Patrick Odonkor Brittney Williams Ali Tabatabai Adnan Bhutta David Ayares David J. Kaczorowski Muhammad M. Mohiuddin |
author_sort |
Corbin E. Goerlich |
title |
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation |
title_short |
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation |
title_full |
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation |
title_fullStr |
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation |
title_full_unstemmed |
Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation |
title_sort |
blood cardioplegia induction, perfusion storage and graft dysfunction in cardiac xenotransplantation |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Immunology |
issn |
1664-3224 |
publishDate |
2021-06-01 |
description |
BackgroundPerioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush following crystalloid or blood-based cardioplegia versus continuous cold perfusion with XVIVO© heart solution (XHS) based cardioplegia.MethodsBaboons were weight matched to genetically engineered swine heart donors. Cardioplegia volume was 30 cc/kg by donor weight, with del Nido cardioplegia and the addition of 25% by volume of donor whole blood. Continuous perfusion was performed using an XVIVO © Perfusion system with XHS to which baboon RBCs were added.ResultsPCXD was observed in 5/8 that were preserved with crystalloid cardioplegia followed by traditional cold, static storage on ice. By comparison, when blood cardioplegia was used followed by cold, static storage, PCXD occurred in 1/3 hearts and only in 1/5 hearts that were induced with XHS blood cardioplegia followed by continuous perfusion. Survival averaged 17 hours in those with traditional preservation and storage, followed by 11.47 days and 15.03 days using blood cardioplegia and XHS+continuous preservation, respectively. Traditional preservation resulted in more inotropic support and higher average peak serum lactate 14.3±1.7 mmol/L compared to blood cardioplegia 3.6±3.0 mmol/L and continuous perfusion 3.5±1.5 mmol/L.ConclusionBlood cardioplegia induction, alone or followed by XHS perfusion storage, reduced the incidence of PCXD and improved graft function and survival, relative to traditional crystalloid cardioplegia-slush storage alone. |
topic |
xenotransplantation graft dysfunction cardiac xenotransplantation cardiac preservation heart transplant heart failure |
url |
https://www.frontiersin.org/articles/10.3389/fimmu.2021.667093/full |
work_keys_str_mv |
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doaj-8e395806941043c1875d5057eb571ee22021-06-09T06:45:30ZengFrontiers Media S.A.Frontiers in Immunology1664-32242021-06-011210.3389/fimmu.2021.667093667093Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac XenotransplantationCorbin E. Goerlich0Corbin E. Goerlich1Bartley Griffith2Avneesh K. Singh3Mohamed Abdullah4Mohamed Abdullah5Shreya Singireddy6Irina Kolesnik7Billeta Lewis8Faith Sentz9Ivan Tatarov10Alena Hershfeld11Tianshu Zhang12Erik Strauss13Patrick Odonkor14Brittney Williams15Ali Tabatabai16Adnan Bhutta17David Ayares18David J. Kaczorowski19Muhammad M. Mohiuddin20Department of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Cardiothoracic Surgery, Cairo University, Cairo, EgyptDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Pediatrics, The University of Maryland School of Medicine, Baltimore, MD, United StatesRevivicor, Inc., Blacksburg, VA, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, The University of Maryland School of Medicine, Baltimore, MD, United StatesBackgroundPerioperative cardiac xenograft dysfunction (PCXD) describes a rapidly developing loss of cardiac function after xenotransplantation. PCXD occurs despite genetic modifications to increase compatibility of the heart. We report on the incidence of PCXD using static preservation in ice slush following crystalloid or blood-based cardioplegia versus continuous cold perfusion with XVIVO© heart solution (XHS) based cardioplegia.MethodsBaboons were weight matched to genetically engineered swine heart donors. Cardioplegia volume was 30 cc/kg by donor weight, with del Nido cardioplegia and the addition of 25% by volume of donor whole blood. Continuous perfusion was performed using an XVIVO © Perfusion system with XHS to which baboon RBCs were added.ResultsPCXD was observed in 5/8 that were preserved with crystalloid cardioplegia followed by traditional cold, static storage on ice. By comparison, when blood cardioplegia was used followed by cold, static storage, PCXD occurred in 1/3 hearts and only in 1/5 hearts that were induced with XHS blood cardioplegia followed by continuous perfusion. Survival averaged 17 hours in those with traditional preservation and storage, followed by 11.47 days and 15.03 days using blood cardioplegia and XHS+continuous preservation, respectively. Traditional preservation resulted in more inotropic support and higher average peak serum lactate 14.3±1.7 mmol/L compared to blood cardioplegia 3.6±3.0 mmol/L and continuous perfusion 3.5±1.5 mmol/L.ConclusionBlood cardioplegia induction, alone or followed by XHS perfusion storage, reduced the incidence of PCXD and improved graft function and survival, relative to traditional crystalloid cardioplegia-slush storage alone.https://www.frontiersin.org/articles/10.3389/fimmu.2021.667093/fullxenotransplantationgraft dysfunctioncardiac xenotransplantationcardiac preservationheart transplantheart failure |