Metabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion

Michael L. Cobert; Matthew E. Merritt; Lashondra M. West; Colby Ayers; Michael E Jessen; Matthias Peltz

doi:10.1016/j.jtcvs.2014.02.023

Metabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion

Michael L. Cobert, Matthew E. Merritt, Lashondra M. West, Colby Ayers, Michael E Jessen, Matthias Peltz

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Results Stable perfusion parameters were maintained throughout the perfusion period with both perfusion techniques. Lactate/alanine ratios were lower in perfused hearts compared with static hearts (P <.001). Lactate accumulation (antegrade 2.0 ± 0.7 mM, retrograde 1.7 ± 0.1 mM) and MVO₂ (antegrade 0.25 ± 0.2 mL, retrograde 0.26 ± 0.3 mL O₂/min/100 g) were similar in machine-perfused groups. High-energy phosphates were better preserved in both perfused groups (P <.05). Left ventricular myocardial water content was increased in retrograde perfused hearts (80.2 ± 0.8%) compared with both antegrade perfused hearts (76.6 ± 0.8%, P =.02) and static storage hearts (76.7 ± 1%, P =.02).

Conclusions Machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion seems promising for long-term preservation of human donor hearts.

Methods Human hearts from donors that were rejected or not offered for transplantation were preserved for 12 hours in University of Wisconsin Machine Perfusion Solution by: (1) static hypothermic storage; (2) hypothermic antegrade machine perfusion; or (3) hypothermic retrograde machine perfusion. Myocardial oxygen consumption (MVO₂), and lactate accumulation were measured. Ventricular tissue was collected for proton and phosphorus 31 magnetic resonance spectroscopy (MRS) to evaluate the metabolic state of the myocardium. Myocardial water content was determined at the end of the experiment.

Objective Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and nonnutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval.

Original language	English (US)
Pages (from-to)	2310-2315.e1
Journal	Journal of Thoracic and Cardiovascular Surgery
Volume	148
Issue number	5
DOIs	https://doi.org/10.1016/j.jtcvs.2014.02.023
State	Published - Nov 1 2014

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine

Access to Document

10.1016/j.jtcvs.2014.02.023

Cite this

Metabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion. / Cobert, Michael L.; Merritt, Matthew E.; West, Lashondra M. et al.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 5, 01.11.2014, p. 2310-2315.e1.

Research output: Contribution to journal › Article › peer-review

@article{9d566f3c230149738b9047e8b3f6a806,

title = "Metabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion",

abstract = "Results Stable perfusion parameters were maintained throughout the perfusion period with both perfusion techniques. Lactate/alanine ratios were lower in perfused hearts compared with static hearts (P <.001). Lactate accumulation (antegrade 2.0 ± 0.7 mM, retrograde 1.7 ± 0.1 mM) and MVO2 (antegrade 0.25 ± 0.2 mL, retrograde 0.26 ± 0.3 mL O2/min/100 g) were similar in machine-perfused groups. High-energy phosphates were better preserved in both perfused groups (P <.05). Left ventricular myocardial water content was increased in retrograde perfused hearts (80.2 ± 0.8%) compared with both antegrade perfused hearts (76.6 ± 0.8%, P =.02) and static storage hearts (76.7 ± 1%, P =.02).Conclusions Machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion seems promising for long-term preservation of human donor hearts.Methods Human hearts from donors that were rejected or not offered for transplantation were preserved for 12 hours in University of Wisconsin Machine Perfusion Solution by: (1) static hypothermic storage; (2) hypothermic antegrade machine perfusion; or (3) hypothermic retrograde machine perfusion. Myocardial oxygen consumption (MVO2), and lactate accumulation were measured. Ventricular tissue was collected for proton and phosphorus 31 magnetic resonance spectroscopy (MRS) to evaluate the metabolic state of the myocardium. Myocardial water content was determined at the end of the experiment.Objective Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and nonnutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval.",

author = "Cobert, {Michael L.} and Merritt, {Matthew E.} and West, {Lashondra M.} and Colby Ayers and Jessen, {Michael E} and Matthias Peltz",

note = "Publisher Copyright: {\textcopyright} 2014 by The American Association for Thoracic Surgery.",

year = "2014",

month = nov,

day = "1",

doi = "10.1016/j.jtcvs.2014.02.023",

language = "English (US)",

volume = "148",

pages = "2310--2315.e1",

journal = "Journal of Thoracic and Cardiovascular Surgery",

issn = "0022-5223",

publisher = "Mosby Inc.",

number = "5",

}

TY - JOUR

T1 - Metabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion

AU - Cobert, Michael L.

AU - Merritt, Matthew E.

AU - West, Lashondra M.

AU - Ayers, Colby

AU - Jessen, Michael E

AU - Peltz, Matthias

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Results Stable perfusion parameters were maintained throughout the perfusion period with both perfusion techniques. Lactate/alanine ratios were lower in perfused hearts compared with static hearts (P <.001). Lactate accumulation (antegrade 2.0 ± 0.7 mM, retrograde 1.7 ± 0.1 mM) and MVO2 (antegrade 0.25 ± 0.2 mL, retrograde 0.26 ± 0.3 mL O2/min/100 g) were similar in machine-perfused groups. High-energy phosphates were better preserved in both perfused groups (P <.05). Left ventricular myocardial water content was increased in retrograde perfused hearts (80.2 ± 0.8%) compared with both antegrade perfused hearts (76.6 ± 0.8%, P =.02) and static storage hearts (76.7 ± 1%, P =.02).Conclusions Machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion seems promising for long-term preservation of human donor hearts.Methods Human hearts from donors that were rejected or not offered for transplantation were preserved for 12 hours in University of Wisconsin Machine Perfusion Solution by: (1) static hypothermic storage; (2) hypothermic antegrade machine perfusion; or (3) hypothermic retrograde machine perfusion. Myocardial oxygen consumption (MVO2), and lactate accumulation were measured. Ventricular tissue was collected for proton and phosphorus 31 magnetic resonance spectroscopy (MRS) to evaluate the metabolic state of the myocardium. Myocardial water content was determined at the end of the experiment.Objective Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and nonnutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval.

AB - Results Stable perfusion parameters were maintained throughout the perfusion period with both perfusion techniques. Lactate/alanine ratios were lower in perfused hearts compared with static hearts (P <.001). Lactate accumulation (antegrade 2.0 ± 0.7 mM, retrograde 1.7 ± 0.1 mM) and MVO2 (antegrade 0.25 ± 0.2 mL, retrograde 0.26 ± 0.3 mL O2/min/100 g) were similar in machine-perfused groups. High-energy phosphates were better preserved in both perfused groups (P <.05). Left ventricular myocardial water content was increased in retrograde perfused hearts (80.2 ± 0.8%) compared with both antegrade perfused hearts (76.6 ± 0.8%, P =.02) and static storage hearts (76.7 ± 1%, P =.02).Conclusions Machine perfusion by either the antegrade or the retrograde technique can support myocardial metabolism over long intervals. Machine perfusion seems promising for long-term preservation of human donor hearts.Methods Human hearts from donors that were rejected or not offered for transplantation were preserved for 12 hours in University of Wisconsin Machine Perfusion Solution by: (1) static hypothermic storage; (2) hypothermic antegrade machine perfusion; or (3) hypothermic retrograde machine perfusion. Myocardial oxygen consumption (MVO2), and lactate accumulation were measured. Ventricular tissue was collected for proton and phosphorus 31 magnetic resonance spectroscopy (MRS) to evaluate the metabolic state of the myocardium. Myocardial water content was determined at the end of the experiment.Objective Machine perfusion of donor hearts is a promising strategy to increase the donor pool. Antegrade perfusion is effective but can lead to aortic valve incompetence and nonnutrient flow. Experience with retrograde coronary sinus perfusion of donor hearts has been limited. We tested the hypothesis that retrograde perfusion could support myocardial metabolism over an extended donor ischemic interval.

UR - http://www.scopus.com/inward/record.url?scp=84911004013&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84911004013&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2014.02.023

DO - 10.1016/j.jtcvs.2014.02.023

M3 - Article

C2 - 24642559

AN - SCOPUS:84911004013

SN - 0022-5223

VL - 148

SP - 2310-2315.e1

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

IS - 5

ER -

Metabolic characteristics of human hearts preserved for 12 hours by static storage, antegrade perfusion, or retrograde coronary sinus perfusion

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this