Marginal donors

Can older donor hearts tolerate prolonged cold ischemic storage?

Sevil Korkmaz, Susanne Bährle-Szabó, Sivakkanan Loganathan, Shiliang Li, Matthias Karck, Gábor Szabó

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and aims: Both advanced donor age and prolonged ischemic time are significant risk factors for the 1-year mortality. However, its functional consequences have not been fully evaluated in the early-phase after transplantation; even early graft dysfunction is the main determinant of long-term outcome following transplantation. We evaluated in vivo left-ventricular (LV) cardiac and coronary vascular function of old-donor grafts after short and prolonged cold ischemic times in rats 1 h after heart transplantation. Methods: The hearts were excised from young donor (3-month-old) or old donor (18-month-old) rats, stored in cold preservation solution for either 1 or 8 h, and heterotopically transplanted. Results: After 1 h of ischemic period, in the old-donor group, LV pressure, maximum pressure development (dP/dt max), time constant of LV pressure decay (τ), LV end-diastolic pressure and coronary blood flow did not differ compared with young donors. However, endothelium-dependent vasodilatation to acetylcholine resulted in a significantly lower response of coronary blood flow in the old-donor group (33 ± 4 vs. 51 ± 15 %, p <0.05). After 8 h preservation, two of the old-donor hearts showed no mechanical activity upon reperfusion. LV pressure (55 ± 6 vs. 72 ± 5 mmHg, p <0.05), dP/dt max (899 ± 221 vs. 1530 ± 217 mmHg/s, p <0.05), coronary blood flow and response to acetylcholine were significantly reduced and τ was increased in the old-donor group in comparison to young controls. Conclusions: During the early-phase after transplantation, the ischemic tolerance of older-donor hearts is reduced after prolonged preservation time and the endothelium is more vulnerable to ischemia/reperfusion.

Original languageEnglish
Pages (from-to)597-600
Number of pages4
JournalAging clinical and experimental research
Volume25
Issue number5
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Ventricular Pressure
Acetylcholine
Reperfusion
Endothelium
Transplantation
Transplantation Tolerance
Transplants
Cold Ischemia
Heart Transplantation
Vasodilation
Blood Vessels
Ischemia
Blood Pressure
Pressure
Mortality

Keywords

  • Cardiac function
  • Endothelial function
  • Heart transplantation
  • Ischemic time
  • Old donor

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

Marginal donors : Can older donor hearts tolerate prolonged cold ischemic storage? / Korkmaz, Sevil; Bährle-Szabó, Susanne; Loganathan, Sivakkanan; Li, Shiliang; Karck, Matthias; Szabó, Gábor.

In: Aging clinical and experimental research, Vol. 25, No. 5, 10.2013, p. 597-600.

Research output: Contribution to journalArticle

Korkmaz, Sevil ; Bährle-Szabó, Susanne ; Loganathan, Sivakkanan ; Li, Shiliang ; Karck, Matthias ; Szabó, Gábor. / Marginal donors : Can older donor hearts tolerate prolonged cold ischemic storage?. In: Aging clinical and experimental research. 2013 ; Vol. 25, No. 5. pp. 597-600.
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AU - Karck, Matthias

AU - Szabó, Gábor

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N2 - Background and aims: Both advanced donor age and prolonged ischemic time are significant risk factors for the 1-year mortality. However, its functional consequences have not been fully evaluated in the early-phase after transplantation; even early graft dysfunction is the main determinant of long-term outcome following transplantation. We evaluated in vivo left-ventricular (LV) cardiac and coronary vascular function of old-donor grafts after short and prolonged cold ischemic times in rats 1 h after heart transplantation. Methods: The hearts were excised from young donor (3-month-old) or old donor (18-month-old) rats, stored in cold preservation solution for either 1 or 8 h, and heterotopically transplanted. Results: After 1 h of ischemic period, in the old-donor group, LV pressure, maximum pressure development (dP/dt max), time constant of LV pressure decay (τ), LV end-diastolic pressure and coronary blood flow did not differ compared with young donors. However, endothelium-dependent vasodilatation to acetylcholine resulted in a significantly lower response of coronary blood flow in the old-donor group (33 ± 4 vs. 51 ± 15 %, p <0.05). After 8 h preservation, two of the old-donor hearts showed no mechanical activity upon reperfusion. LV pressure (55 ± 6 vs. 72 ± 5 mmHg, p <0.05), dP/dt max (899 ± 221 vs. 1530 ± 217 mmHg/s, p <0.05), coronary blood flow and response to acetylcholine were significantly reduced and τ was increased in the old-donor group in comparison to young controls. Conclusions: During the early-phase after transplantation, the ischemic tolerance of older-donor hearts is reduced after prolonged preservation time and the endothelium is more vulnerable to ischemia/reperfusion.

AB - Background and aims: Both advanced donor age and prolonged ischemic time are significant risk factors for the 1-year mortality. However, its functional consequences have not been fully evaluated in the early-phase after transplantation; even early graft dysfunction is the main determinant of long-term outcome following transplantation. We evaluated in vivo left-ventricular (LV) cardiac and coronary vascular function of old-donor grafts after short and prolonged cold ischemic times in rats 1 h after heart transplantation. Methods: The hearts were excised from young donor (3-month-old) or old donor (18-month-old) rats, stored in cold preservation solution for either 1 or 8 h, and heterotopically transplanted. Results: After 1 h of ischemic period, in the old-donor group, LV pressure, maximum pressure development (dP/dt max), time constant of LV pressure decay (τ), LV end-diastolic pressure and coronary blood flow did not differ compared with young donors. However, endothelium-dependent vasodilatation to acetylcholine resulted in a significantly lower response of coronary blood flow in the old-donor group (33 ± 4 vs. 51 ± 15 %, p <0.05). After 8 h preservation, two of the old-donor hearts showed no mechanical activity upon reperfusion. LV pressure (55 ± 6 vs. 72 ± 5 mmHg, p <0.05), dP/dt max (899 ± 221 vs. 1530 ± 217 mmHg/s, p <0.05), coronary blood flow and response to acetylcholine were significantly reduced and τ was increased in the old-donor group in comparison to young controls. Conclusions: During the early-phase after transplantation, the ischemic tolerance of older-donor hearts is reduced after prolonged preservation time and the endothelium is more vulnerable to ischemia/reperfusion.

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KW - Endothelial function

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KW - Ischemic time

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