AVOIDANCE OF PROFOUND HYPOTHERMIA DURING INITIAL REPERFUSION IMPROVES THE FUNCTIONAL RECOVERY OF DCD HEARTS

Abstract

s S251 normothermic beating state and transitioned into working mode for assessment of myocardial function by measuring the cardiac index (mL/minute/gram heart tissue) achieved at a left atrial pressure of 8 mmHg and an aortic diastolic pressure of 40 mmHg. RESULTS: Hearts sustained an equivalent period of warm ischemia (5 C1⁄428 1, 25 C1⁄429 1, 35 C1⁄427 1 minutes, p1⁄40.50) prior to IR. During IR coronary blood flow (5 C1⁄4483 53, 25 C1⁄4722 60, 35 C1⁄4906 36 mL/min, p<0.01) and coronary sinus lactate concentration (5 C1⁄4 0.73 0.06, 25 C1⁄41.33 0.03, 35 C1⁄41.75 0.15 umol/L, p<0.01) differed among treatment groups. Greater preservation of endothelial cell integrity (electron microscopy endothelial injury score: 5 C1⁄43.2 0.5, 25 C1⁄41.8 0.2, 35 C1⁄41.7 0.3, p1⁄40.01) and less myocardial injury (troponin I: 5 C1⁄491 6, 25 C1⁄464 16, 35 C1⁄457 7 pg/ mL/gram, p1⁄40.04) were evident in hearts reperfused at warmer temperatures. IR under profoundly hypothermic conditions impaired the recovery of indexed cardiac output (5 C1⁄43.9 0.8, 25 C1⁄46.2 0.4, 35 C1⁄46.5 0.0.6 mL/min/ gram, p<0.01). CONCLUSION: Avoidance of profound hypothermia during IR with a normokalemic adenosine-lidocaine cardioplegia minimizes injury and improves the functional recovery of DCD hearts. 384 GENDER SPECIFIC INFLUENCES ON EFFECTOR T-CELL FUNCTION AND PROLIFERATION: 2-METHOXYESTRADIOL MODULATES CELLULAR REJECTION JG Luc, JY Zhao, ED Michelakis, DH Freed, J Nagendran