Kuhn-Régnier Ferdinand, Bloch Wilhelm, Tsimpoulis Ilias, Reismann Marc, Dagktekin Oguzan, Jeschkeit-Schubbert Stefanie, Funcke Claudia, Fries Jochen W U, Addicks Klaus, de Vivie Ernst R, Fischer Jürgen H
Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany.
Transplantation. 2004 Jan 15;77(1):28-35. doi: 10.1097/01.TP.0000090162.96787.D0.
Coronary oxygen persufflation (COP) has been shown to prolong heart preservation time up to 14 hr in a mature pig model, with excellent recovery after orthotopic transplantation. The aim of the present study was to assess the structural, metabolic, and functional myocardial and endothelial integrity after COP in mature pig hearts.
Cardioplegic arrest was induced by original crystalloid Bretschneider solution (HTK 3h, n=6), modified Bretschneider solution (mHTK+COP, n=6), or University of Wisconsin solution (UW+COP, n=6). Hearts were stored for 3 (HTK 3h) or 14 hr (mHTK+COP, UW+COP) at 0 degrees to 1 degrees C. In addition, COP hearts were persufflated. After heterotopic transplantation and reperfusion for 7 days, hearts were analyzed by light microscopy or electron microscopy for structural injuries. Endothelial function, cardiac enzymes, metabolic parameters, and myocardial water content (MWC) were determined. Six recipient hearts served as controls.
Quantitative light microscopic analyses and semiquantitative electron microscopic analyses showed an equal amount of damage in all groups including HTK 3h hearts. No rejection was observed. Substance P induced an equal dilatation in all hearts. Serum levels of cardiac enzymes were similar in all groups, but energy-enriched phosphates were significantly reduced, and MWC was augmented in the HTK 3h hearts and in the UW+COP hearts, in contrast to the mHTK+COP transplants.
The lack of structural defects related to the COP technique, similar endothelial function, and an even better metabolic state of the mHTK+COP hearts versus HTK 3h hearts demonstrate the efficacy of the COP technique for prolongation of myocardial preservation time up to 14 hr.
在成熟猪模型中，冠状动脉持续氧合灌注（COP）已被证明可将心脏保存时间延长至14小时，原位移植后恢复良好。本研究的目的是评估成熟猪心脏在COP后心肌和内皮的结构、代谢及功能完整性。
用原始晶体Bretschneider溶液（HTK 3h，n = 6）、改良Bretschneider溶液（mHTK + COP，n = 6）或威斯康星大学溶液（UW + COP，n = 6）诱导心脏停搏。心脏在0至1摄氏度下保存3小时（HTK 3h）或14小时（mHTK + COP，UW + COP）。此外，对COP心脏进行持续氧合灌注。异位移植并再灌注7天后，通过光学显微镜或电子显微镜分析心脏的结构损伤。测定内皮功能、心肌酶、代谢参数和心肌含水量（MWC）。六个受体心脏作为对照。
定量光学显微镜分析和半定量电子显微镜分析显示，包括HTK 3h心脏在内的所有组损伤程度相同。未观察到排斥反应。P物质在所有心脏中引起相同程度的扩张。所有组中心肌酶的血清水平相似，但富含能量的磷酸盐显著降低，与mHTK + COP移植相比，HTK 3h心脏和UW + COP心脏中的MWC增加。
与COP技术相关的结构缺陷不存在、内皮功能相似，且mHTK + COP心脏相对于HTK 3h心脏具有更好的代谢状态，证明了COP技术在将心肌保存时间延长至14小时方面的有效性。
