Amir Gabriel, Rubinsky Boris, Horowitz Liana, Miller Liron, Leor Jonathan, Kassif Yigal, Mishaly David, Smolinsky Aram K, Lavee Jacob
Heart Transplantation Unit, Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Ann Thorac Surg. 2004 May;77(5):1648-55. doi: 10.1016/j.athoracsur.2003.04.004.
Arctic fish survive subzero temperatures by producing a family of antifreeze proteins (AFPs) that noncolligatively lower the freezing temperature of their body fluids. We report 24-hour storage of mammalian hearts for transplantation at subzero temperatures using AFPs derived from arctic fish.
Forty-two heterotopic transplantations were performed in isoimmune Sprague-Dawley rats. Harvested hearts were retrogradely infused with cold 4 degrees C University of Wisconsin (UW) solution and were preserved in a specialized cooling bath at two target temperatures, 4 degrees C and -1.3 degrees C for 12,18, and 24 hours (6 experiments/group). Preservation solutions were UW alone for the 4 degrees C group, and UW with 15 mg/mL AFP III for the -1.3 degrees C group. After hypothermic storage the hearts were heterotopically transplanted into isoimmune rats. Viability was assessed and graded on a scale of 0 to 6 (0 = no contractions to 6 = excellent contractions). Transplanted hearts were then fixed in vivo and were subject to electron microscopy and histopathologic examination.
None of the hearts preserved at -1.3 degrees C in UW/AFP III solution froze. All control hearts preserved at -1.3 degrees C without AFP protection froze and died at reperfusion. Viability of hearts preserved at -1.3 degrees C in UW/AFP III solution was significantly better after 18 hours of preservation, 30 and 60 minutes after reperfusion (median, 5 versus 3 and 6 versus 3, respectively; p < 0.05) and after 24 hours of preservation 30 and 60 minutes after reperfusion (median, 4.5 versus 1.5 and 5 versus 2, respectively; p < 0.05). Histologic and electron microscopy studies demonstrated better myocyte structure and mitochondrial integrity preservation with UW/AFP III solution.
Antifreeze proteins prevent freezing in subzero cryopreservation of mammalian hearts for transplantation. Subzero preservation prolongs ischemic times and improves posttransplant viability.
北极鱼类通过产生一类抗冻蛋白(AFP)来在零度以下的温度中生存,这类蛋白能非依数性地降低其体液的冰点。我们报告了使用源自北极鱼类的抗冻蛋白在零度以下温度对用于移植的哺乳动物心脏进行24小时保存。
在同基因免疫的斯普拉格-道利大鼠中进行了42次异位移植。收获的心脏用冷的4℃威斯康星大学(UW)溶液逆行灌注,并在一个专门的冷却浴中于两个目标温度(4℃和-1.3℃)保存12、18和24小时(每组6个实验)。4℃组的保存液仅为UW,而-1.3℃组的保存液为含15mg/mL抗冻蛋白III的UW。低温保存后,将心脏异位移植到同基因免疫大鼠体内。评估心脏活力并按0至6级进行分级(0级=无收缩至6级=收缩良好)。然后将移植的心脏在体内固定,并进行电子显微镜和组织病理学检查。
在UW/抗冻蛋白III溶液中于-1.3℃保存的心脏均未冻结。所有在无抗冻蛋白保护的情况下于-1.3℃保存的对照心脏均冻结并在再灌注时死亡。在UW/抗冻蛋白III溶液中于-1.3℃保存的心脏,在保存18小时后、再灌注30和60分钟时(中位数分别为5比3和6比3;p<0.05)以及在保存24小时后、再灌注30和60分钟时(中位数分别为4.5比1.5和5比2;p<0.05),其活力明显更好。组织学和电子显微镜研究表明,UW/抗冻蛋白III溶液能更好地保存心肌细胞结构和线粒体完整性。
抗冻蛋白可防止用于移植的哺乳动物心脏在零度以下低温保存时冻结。零度以下保存可延长缺血时间并改善移植后的活力。