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Marginal donors: can older donor hearts tolerate prolonged cold ischemic storage?

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Abstract

Background and aims

Both advanced donor age and prolonged ischemic time are significant risk factors for the 1-year mortality. However, its functional consequences have not been fully evaluated in the early-phase after transplantation; even early graft dysfunction is the main determinant of long-term outcome following transplantation. We evaluated in vivo left-ventricular (LV) cardiac and coronary vascular function of old-donor grafts after short and prolonged cold ischemic times in rats 1 h after heart transplantation.

Methods

The hearts were excised from young donor (3-month-old) or old donor (18-month-old) rats, stored in cold preservation solution for either 1 or 8 h, and heterotopically transplanted.

Results

After 1 h of ischemic period, in the old-donor group, LV pressure, maximum pressure development (dP/dt max), time constant of LV pressure decay (τ), LV end-diastolic pressure and coronary blood flow did not differ compared with young donors. However, endothelium-dependent vasodilatation to acetylcholine resulted in a significantly lower response of coronary blood flow in the old-donor group (33 ± 4 vs. 51 ± 15 %, p < 0.05). After 8 h preservation, two of the old-donor hearts showed no mechanical activity upon reperfusion. LV pressure (55 ± 6 vs. 72 ± 5 mmHg, p < 0.05), dP/dt max (899 ± 221 vs. 1530 ± 217 mmHg/s, p < 0.05), coronary blood flow and response to acetylcholine were significantly reduced and τ was increased in the old-donor group in comparison to young controls.

Conclusions

During the early-phase after transplantation, the ischemic tolerance of older-donor hearts is reduced after prolonged preservation time and the endothelium is more vulnerable to ischemia/reperfusion.

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Authors and Affiliations

  1. Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany

    Sevil Korkmaz, Susanne Bährle-Szabó, Sivakkanan Loganathan, Shiliang Li, Matthias Karck & Gábor Szabó

Authors
  1. Sevil Korkmaz
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  2. Susanne Bährle-Szabó
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  3. Sivakkanan Loganathan
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  4. Shiliang Li
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  5. Matthias Karck
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  6. Gábor Szabó
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Correspondence to Sevil Korkmaz.

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Korkmaz, S., Bährle-Szabó, S., Loganathan, S. et al. Marginal donors: can older donor hearts tolerate prolonged cold ischemic storage?. Aging Clin Exp Res 25, 597–600 (2013). https://doi.org/10.1007/s40520-013-0131-9

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  • DOI: https://doi.org/10.1007/s40520-013-0131-9

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