Abstract
Purpose Static cold storage of hearts from brain dead donors is still the mainstay in cardiac transplantation. The risk of ischaemia-reperfusion injury (IRI) and primary graft failure (PGF) are significant disadvantages of this method. We found that three ‘conditioning’ agents–Glyceryl trinitrate (G), Erythropoietin€ and Zoniporide (Z), when added to standard preservation solutions, attenuate IRI in rat hearts. We aimed to test their efficacy in hearts from brain dead rats in prolonged cold storage. Methods and Materials Rats were subjected to brain death (BD) by inflation of a subdural embolectomy catheter. Invasive haemodynamic changes are shown in Figure 1 . Cardiac function was assessed on an isolated working heart model (IWHM), then hearts arrested and preserved in Celsior for 1, 3 or 6 hours (n=6 each sub-group). Additional hearts from BD donors were arrested and stored for 3 or 6 hours using Celsior with G+E+Z (n=6 for 3h, 6h) and function re-assessed on an IWHM. Results BD hearts had inferior recovery of cardiac output (CO) cf with shams. Supplementing Celsior with G+E+Z significantly improved CO in BD hearts (p Conclusions G, E & Z that activate ‘conditioning’ pathways significantly improve recovery of BD rat hearts after prolonged static cold storage. This data warrants assessing these strategies clinically. [ figure 2 ]
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