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Quantifying Cardiac Injury with Donation after Circulatory Death Process: Impact of Donor Age and Obesity
Author(s) -
Akande Oluwatoyin Elizabeth,
Chen Qun,
Toldo Stefano,
Lesnefsky Edward,
Quader Mohammed
Publication year - 2020
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2020.34.s1.04137
Subject(s) - medicine , ventricle , cardiology , cardiac function curve , ischemia , economic shortage , circulatory system , transplantation , heart failure , linguistics , philosophy , government (linguistics)
Heart transplantation, the gold standard treatment for patients with advanced heart failure, is limited due to shortage of suitable donor hearts, which at the present are procured from Brain Death Donors (DBD) only. Recent advancement in organ procurement and retrieval techniques have shown that Donation after Circulatory Death (DCD) promises to expand the heart donor pool. While ischemic insult is inherent in the DCD process, subsequent reperfusion injury is inevitable in these hearts. Donor age and obesity may adversely affect the function of a DCD heart. We herein hypothesize that age and obesity may influence the outcome of cardiac injury in DCD hearts. Methods SD rats ages between 13 and 17 weeks, weighing between 340 and 430 grams were subjected to 25min of warm ischemia following the DCD protocol. Hearts from these DCD rat models were reanimated on Langendorff system primed with KH buffer at 37°C, and perfused at steady 73mmHg for 60 minutes, to obtain cardiac function (left ventricle developed pressure‐LVDP, positive and negative dP/dt) data. Results Following 25 min of warm ischemia in vivo, we observed lower LVDP (43±10 mmHg) in DCD hearts from rats older than16 weeks or weighing more than 370 grams when compared with LVDP ( 64±12 mmHg ) in hearts from rats younger than 16 weeks of age or weighing less than 370 grams. Similar trend was noted in positive and negative dP/dt values. The decrease in DCD heart function was near linear with both increasing age and weight (Figure 1). Conclusions Based on our findings, age and obesity of DCD donor influences susceptibility to warm ischemia. These donor factors need to be taken into consideration when designing studies involving DCD rat hearts.