Comparison of Different Ex-Vivo Preservation Strategies on Cardiac Metabolism in an Animal Model of Donation after Circulatory Death

Stefano Mastrobuoni; Manuel Johanns; Martial Vergauwen; Gwen Beaurin; Mark Rider; Pierre Gianello; Alain Poncelet; Olivier Van Caenegem

doi:10.3390/jcm12103569

Comparison of Different Ex-Vivo Preservation Strategies on Cardiac Metabolism in an Animal Model of Donation after Circulatory Death

J Clin Med. 2023 May 20;12(10):3569. doi: 10.3390/jcm12103569.

Authors

Stefano Mastrobuoni^{1

2}, Manuel Johanns³, Martial Vergauwen², Gwen Beaurin², Mark Rider³, Pierre Gianello², Alain Poncelet^{1

2}, Olivier Van Caenegem^{2

4}

Affiliations

¹ Cardiovascular and Thoracic Surgery Department, Saint-Luc's Hospital, Catholic University of Louvain, 1200 Brussels, Belgium.
² Pole de Chirurgie Expérimentale et Transplantation, Institut de Recherche Expérimentale et Clinique (IREC), Catholic University of Louvain, 1200 Brussels, Belgium.
³ Pole de Biochimie et Recherche Metabolique, Institue de Duve, Catholic University of Louvain, 1200 Brussels, Belgium.
⁴ Cardiac Intensive Care Unit, Saint-Luc's Hospital, Catholic University of Louvain, 1200 Brussels, Belgium.

Abstract

Transplantation of heart following donation after circulatory death (DCD) was recently introduced into clinical practice. Ex vivo reperfusion following DCD and retrieval is deemed necessary in order to evaluate the recovery of cardiac viability after the period of warm ischemia. We tested the effect of four different temperatures (4 °C-18 °C-25 °C-35 °C) on cardiac metabolism during 3-h ex vivo reperfusion in a porcine model of DCD heart. We observed a steep fall in high-energy phosphate (ATP) concentrations in the myocardial tissue at the end of the warm ischemic time and only limited regeneration during reperfusion. Lactate concentration in the perfusate increased rapidly during the first hour of reperfusion and slowly decreased afterward. However, the temperature of the solution does not seem to have an effect on either ATP or lactate concentration. Furthermore, all cardiac allografts showed a significant weight increase due to cardiac edema, regardless of the temperature.

Keywords: donation after circulatory death; ex-vivo machine perfusion; heart transplant.

Grants and funding

M.J. is postdoctoral Chargé de Recherche’ fellow of the Fonds de la Recherche Scientifique (FNRS, Belgium). Work in MHR’s laboratory was funded by the FNRS Belgium under Grant number T.0008.15.