Abstract
ObjectiveTo investigate the effect of Shenfu (SF) injection on donor heart preservation.MethodsTwelve pigs were randomly divided into SF group (n=6) and control group (n=6). After eight hours of perfusion, the differences in hemoglobin, the expression of Bcl-2 and BAX, and changes in the myocardial ultrastructure were compared to illustrate the effects of SF injection in heart preservation.ResultsThe differences in free hemoglobin between the SF group and the control group were statistically significant (P=0.001), and there was significant interaction of groups with times (P=0.019), but the perfusion time may not be associated with the hemoglobin concentration (P=0.616). According to Western blotting analysis, the expression of Bcl-2 was higher in the SF group than in the control group, while the expression of BAX was not different between the two groups. As to ultrastructural changes, both groups exhibited mitochondrial swelling and myofilament lysis, but the degree of damage in the SF group was smaller.ConclusionOur study suggests that the application of SF injection for heart preservation may protect against cardiomyocytes and erythrocytes apoptosis, and Bcl-2 protein may play a role in these physiological processes.
Highlights
In order to optimize the effect of heart preservation, new approaches have been explored
Our study suggests that the application of SF injection for heart preservation may protect against cardiomyocytes and erythrocytes apoptosis, and Bcl-2 protein may play a role in these physiological processes
The inflammatory environment has an adverse effect on the myocardium, vascular intima, and erythrocytes
Summary
In order to optimize the effect of heart preservation, new approaches have been explored. Continuous perfusion of harvested hearts can safely prolong the preservation period compared with cold static storage[1,2,3]. Ischemia-reperfusion injury is inevitable, and continuous perfusion of harvested hearts can provide a near-physiologic environment for the heart by continuously infusing it with a warm, oxygen-rich medium. It cannot only provide sufficient nutrients, and ensure the effective removal of metabolic waste. It can lighten the ischemia-reperfusion injury induced by low temperature and avoid hyperkalemia. Severe mechanical damage and inflammatory mediators attack erythrocytes, resulting in increased free hemoglobin in the blood, which causes free hydroxyl production and lipid peroxidation, leading to tissue damage
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