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Hearts From DCD Donors Display Acceptable Biventricular Function After Heart Transplantation in Pigs
Author(s) -
Ali A. A.,
White P.,
Xiang B.,
Lin HY.,
Tsui S. S.,
Ashley E.,
Lee T.W.,
Klein J. R. H.,
Kumar K.,
Arora R. C.,
Large S. R.,
Tian G.,
Freed D. H.
Publication year - 2011
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2011.03622.x
Subject(s) - medicine , transplantation , cardiac function curve , heart transplantation , cardiology , circulatory system , resuscitation , cardiopulmonary resuscitation , contractility , stroke volume , heart failure , anesthesia , ejection fraction
Cardiac transplantation is in decline, in contrast to other solid organs where the number of solid organ transplants from donors after circulatory death (DCD) is increasing. Hearts from DCD donors are not currently utilized due to concerns that they may suffer irreversible cardiac injury with resultant poor graft function. Using a large animal model, we tested the hypothesis that hearts from DCD donors would be suitable for transplantation. Donor pigs were subjected to hypoxic cardiac arrest (DCD) followed by 15 min of warm ischemia and resuscitation on cardiopulmonary bypass, or brainstem death (BSD) via intracerebral balloon inflation. Cardiac function was assessed through load‐independent measures and magnetic resonance imaging and spectroscopy. After resuscitation, DCD hearts had near normal contractility, although stroke volume was reduced, comparable to BSD hearts. DCD hearts had a significant decline in phosphocreatine and increase in inorganic phosphate during the hypoxic period, with a return to baseline levels after reperfusion. After transplantation, cardiac function was comparable between BSD and DCD groups. Therefore, in a large animal model, the DCD heart maintains viability and recovers function similar to that of the BSD heart and may be suitable for clinical transplantation. Further study is warranted on optimal reperfusion strategies.