Superior myocardial preservation with HTK solution over Celsior in rat hearts with prolonged cold ischemia

Surgery. 2010 Aug;148(2):463-73. doi: 10.1016/j.surg.2010.04.009. Epub 2010 Jun 2.

Abstract

Background: Increasing allograft ischemic time is a significant risk factor for mortality following heart transplantation (HTx). The purpose of this study was to evaluate the protective effects of histidine-tryptophan-ketoglutarate (HTK) and Celsior (CEL) using a rat HTx model with prolonged cold storage.

Methods: The hearts were excised from donor rats, stored in cold preservation solution for either 6 or 18 hours, and heterotopically transplanted into syngeneic recipients. Serum creatine phosphokinase (CPK), serum troponin I, graft-infiltrating cells, graft mRNA levels for inflammatory mediators, and tissue adenosine triphosphate (ATP) levels were analyzed, as markers of graft injury.

Results: The recipients of grafts stored in HTK for 18 hours of prolonged cold ischemia had lower levels of serum CPK and tissue malondialdehyde, less upregulation of the mRNAs for IL-6 and inducible nitric oxide synthase, less apoptosis, and higher ATP levels than those receiving grafts stored in CEL and Saline. Cardiac contraction 3 hours after reperfusion was observed in 43% of the cardiac grafts stored in HTK for 18 hours, while no cardiac wall movement was seen in grafts stored in either saline or CEL.

Conclusion: Cold storage in HTK exhibited superior protective effects against prolonged cold ischemia in a syngeneic rat transplantation model.

MeSH terms

  • AMP-Activated Protein Kinases / metabolism
  • Adenosine Triphosphate / metabolism
  • Animals
  • Apoptosis
  • Cold Ischemia
  • Creatine Kinase / blood
  • Disaccharides
  • Electrolytes
  • Glucose
  • Glutamates
  • Glutathione
  • Heart Transplantation* / pathology
  • Heart Transplantation* / physiology
  • Heart*
  • Histidine
  • In Vitro Techniques
  • Inflammation Mediators / metabolism
  • Lipid Peroxidation
  • Male
  • Mannitol
  • Microscopy, Electron, Transmission
  • Myocardial Contraction
  • Myocardial Reperfusion Injury / blood
  • Myocardial Reperfusion Injury / pathology
  • Myocardial Reperfusion Injury / physiopathology
  • Myocardial Reperfusion Injury / prevention & control
  • Neutrophils / pathology
  • Organ Preservation / methods*
  • Organ Preservation Solutions*
  • Potassium Chloride
  • Procaine
  • RNA, Messenger / genetics
  • RNA, Messenger / metabolism
  • Rats
  • Rats, Inbred Lew
  • Troponin I / blood

Substances

  • Bretschneider cardioplegic solution
  • Celsior
  • Disaccharides
  • Electrolytes
  • Glutamates
  • Inflammation Mediators
  • Organ Preservation Solutions
  • RNA, Messenger
  • Troponin I
  • Mannitol
  • Histidine
  • Procaine
  • Potassium Chloride
  • Adenosine Triphosphate
  • AMP-Activated Protein Kinases
  • Creatine Kinase
  • Glutathione
  • Glucose