Research efficiency of hypothermia prfusion of donor visceral cavities with circulatory arrest to prolong myocardium vital capacity of donor heart in experiment

Abstract

Introduction. In transplantology, there has always been a problem of organ donor shortage, especially hearts. One of the possible ways to increase the pool of donor hearts is to use donors with circulatory arrest, however irreversible changes in the myocardium after circulatory arrest progress rapidly, which significantly complicates the use of a heart removed from an asystolic donor for transplantation. Objective. To evaluate the effectiveness of hypothermic perfusion of visceral cavities (HPVC) as a method of prolonging the viability of the myocardium of the donor heart during asystole. Materials and methods. The experiments were performed on male rats weighing 200–250 g. The animals were divided into 5 groups, deepening on the duration of HPVC, carried out after a 10-minute period of normothermal asystole: control – 0 min. HPVC and groups with HPVC lasting 30, 60, 90 and 120 min. After complete of perfusion of the heart cavities, they were connected to a Langendorff apparatus to evaluate functional parameters and then determine the volume of necrosis. Results. By the tenth minute of the asystole, the core temperature of the rats’ body was 37.2 ± 0.3 °C. The size of necrosis in the control group was 4.1± 0.6 %. In the groups with a duration of HPVC of 30, 60, and 90 minutes, the size of necrosis was significantly higher than in the control (p<0.05), and was 13.4±3.6 %, 10.3±4.4 % and 14.1±3.4 %, respectively, but there were no difference between these groups. There was a significant increase of the necrosis size in the group with HPVC lasting 120 min compared with the HPVC lasting 90 minutes (24.2±7.1 %, p><0.05). Conclusions. Cold perfusion of the visceral cavities of an asystolic donor, initiated 10 minutes after circulatory arrest, can significantly slow the progression of irreversible myocardial damage in up to 90 minutes, which can expand the potential for the use of hearts from asystolic donors.>< 0.05), and was 13.4±3.6 %, 10.3±4.4 % and 14.1±3.4 %, respectively, but there were no difference between these groups. There was a significant increase of the necrosis size in the group with HPVC lasting 120 min compared with the HPVC lasting 90 minutes (24.2±7.1 %, p< 0.05). Conclusions. Cold perfusion of the visceral cavities of an asystolic donor, initiated 10 minutes after circulatory arrest, can significantly slow the progression of irreversible myocardial damage in up to 90 minutes, which can expand the potential for the use of hearts from asystolic donors.