Cold static storage (CSS) and normothermic ex-situ preservation are the most widely used donor heart preservation techniques worldwide. The current study compares both CSS and normothermic ex-situ preservation methods in terms of graft performance, morphologic changes, and acute immune response in an experimental model. Twenty rats underwent heterotopic abdominal heart transplantation after 2h of CSS (group 1; n=10) or normothermic ex-situ perfusion (group 2; n=10). Blood samples were obtained from recipients just before and after 4h of transplantation to analyze surface markers of immune cells and cytokines. Electrocardiography and echocardiography were performed before donor heart harvesting and after heterotopic transplantation. After 4h of transplantation, donor hearts were extracted for further histologic studies. All recipient animals in both groups successfully survived after heterotopic transplantation. The mean ischemic time of the donor heart was 163±8.34mins in group 1 and 43.8±6.97mins in group 2 (P<0.01). Ejection fraction significantly decreased after transplantation in both groups but were less significant in group 2 (the mean difference group 1: -34.3±3.54, P<0.01; group 2: -14.3±15.47, P=0.01). The percentage of granulocyte significantly increased in both group 1 and group 2, but the significance was more pronounced in group 1 (the mean difference group 1: 48.7±5.36, P<0.01; group 2: 39.7±13.1, P<0.01). Normothermic ex-situ perfusion is associated with well-preserved donor hearts but a similar recipient acute immune response in comparison with CSS in the rat model.
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