Abstract 19457: Succesfull Heart Transplantation after Twelve Hours of Cold Ischemic Storage in the Novel Organ Preservation Solution, Custodiol-N
Objective: We currently developed a novel HTK based solution Custodiol-N which includes iron chelators to reduce oxidative injury and amino acids, in particular L-arginine, to improve endothelial function. We investigated the effects of Custodiol-N, on ischemia/reperfusion injury in a canine orthotopic heart transplant model.
Methods: After 4, 8, and 12 hours of ischemic preservation, 36 orthotopic heart transplantations were performed. The hearts were preserved with either HTK (Custudiol, control) or Custodiol-N solution. The slope of the left ventricular pressure-volume relationships (Ees) was calculated before explantation and after 120 minutes of reperfusion. Coronary blood flow (CBF), endothelium-dependent vasodilatation to acetylcholine (ACH) and endothelium-independent vasodilatation to sodium nitroprusside (SNP) were also determined.
Results: Custodiol-N led to significantly better recovery of Ees (91±5 vs. 49±8%, p<0.05). CBF was significantly higher in the Custodiol-N group (53±5 vs. 27±4, ml/min, p<0.05). While the vasodilatatory response to SNP was similar in both groups, ACH resulted in a significantly higher increase in CBF in the Custodiol-N group (72±8% vs. 29±7%, p<0.05). While none of the control animals could wean from cardiopulmonary bypass after 8 and 12 hours of ischemic preservation, all the animals could successfully weaned both after 8 and 12 hours in the Custodiol-N group. The recovery of Ees was 88±6% and 92±8%, respectively which did not differ significantly from baseline values.
Conclusions: The novel organ preservation solution, Custodiol-N, reduces myocardial and endothelial reperfusion injury after orthotopic heart transplantation and successfully extends the safe hypothermic ischemic cardiac preservation times up to 12 hours.
- © 2012 by American Heart Association, Inc.