TY - JOUR
T1 - Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation
AU - Goerlich, Corbin E.
AU - Griffith, Bartley
AU - Singh, Avneesh K.
AU - Abdullah, Mohamed
AU - Singireddy, Shreya
AU - Kolesnik, Irina
AU - Lewis, Billeta
AU - Sentz, Faith
AU - Tatarov, Ivan
AU - Hershfeld, Alena
AU - Zhang, Tianshu
AU - Strauss, Erik
AU - Odonkor, Patrick
AU - Williams, Brittney
AU - Tabatabai, Ali
AU - Bhutta, Adnan
AU - Ayares, David
AU - Kaczorowski, David J.
AU - Mohiuddin, Muhammad M.
N1 - Publisher Copyright:
© Copyright © 2021 Goerlich, Griffith, Singh, Abdullah, Singireddy, Kolesnik, Lewis, Sentz, Tatarov, Hershfeld, Zhang, Strauss, Odonkor, Williams, Tabatabai, Bhutta, Ayares, Kaczorowski and Mohiuddin.
PY - 2021/6/9
Y1 - 2021/6/9
N2 - Background: Perioperative 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. Methods: Baboons 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. Results: PCXD 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. Conclusion: Blood 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.
AB - Background: Perioperative 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. Methods: Baboons 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. Results: PCXD 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. Conclusion: Blood 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.
KW - cardiac preservation
KW - cardiac xenotransplantation
KW - graft dysfunction
KW - heart failure
KW - heart transplant
KW - ventricular assist device (VAD)
KW - xenotransplantation
UR - http://www.scopus.com/inward/record.url?scp=85108382696&partnerID=8YFLogxK
U2 - 10.3389/fimmu.2021.667093
DO - 10.3389/fimmu.2021.667093
M3 - Article
C2 - 34177906
AN - SCOPUS:85108382696
SN - 1664-3224
VL - 12
JO - Frontiers in Immunology
JF - Frontiers in Immunology
M1 - 667093
ER -