Comparison of Custodiol vs warm blood cardioplegia and conditioning of donor hearts during transportation with the organ care system

Comparison of Custodiol vs warm blood cardioplegia and conditioning of donor hearts during transportation with the organ care system

Objectives Cold crystalloid cardioplegia for donor heart harvesting and cold ischemic storage conditions during the transportation is the standard of care during heart transplantation procedure. Organ care system (OCS) was introduced for more prolonged and reliable ex vivo organ management. This stu...

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Bibliographic Details
Published in:Journal of cardiac surgery Vol. 34; no. 10; pp. 969 - 975
Main Authors: Kaliyev, Rymbay, Lesbekov, Timur, Bekbossynov, Serik, Bekbossynova, Makhabbat, Nurmykhametova, Zhuldyz, Novikova, Svetlana, Smagulov, Nurlan, Medressova, Assel, Faizov, Linar, Ashyrov, Zhanibek, Fleur, Philip, Samalavicius, Robertas, Pya, Yuriy
Format: Journal Article
Language:English
Published: United States John Wiley and Sons Inc 01-10-2019
Subjects:
Adult
blood cardioplegia
ex vivo perfusion
Female
Follow-Up Studies
Glucose - pharmacology
Heart Arrest, Induced - methods
Heart Failure - surgery
heart transplantation
Heart Transplantation - methods
Humans
interleukin
Male
Mannitol - pharmacology
Organ Preservation - methods
Organ Preservation Solutions - pharmacology
Original
Perfusion - methods
Potassium Chloride - pharmacology
Procaine - pharmacology
Prospective Studies
Tissue Donors
blood cardioplegia
ex vivo perfusion
interleukin
heart transplantation
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Summary:Objectives Cold crystalloid cardioplegia for donor heart harvesting and cold ischemic storage conditions during the transportation is the standard of care during heart transplantation procedure. Organ care system (OCS) was introduced for more prolonged and reliable ex vivo organ management. This study evaluated the two different techniques used for myocardial preservation during the procurement and transportation of the heart using the OCS. Methods We performed prospective analysis of 43 patients with heart failure undergoing heart transplantation and using the OCS for donor organ transport. Donor hearts were arrested using blood cardioplegia and conditioning (n = 30) or standard Custodiol (SC) solution ( n = 13). Perfusion and cardiac function parameters were continuously monitored while the donor hearts were perfused in the OCS. Impact of preservation techniques on biochemical parameters and clinical outcomes were evaluated. Results All donor hearts had stable perfusion and lactate characteristics in the OCS, with similar measures between the two groups at the beginning of the ex vivo perfusion. Ex vivo heart perfusion mean ending concentration of Interleukin (IL)‐6 and IL‐8 was significantly lower in the blood cardioplegia group compared to the standard care group. Clinical outcomes were comparable between the two groups of patients. Conclusions The use of blood cardioplegia and conditioning could be a safe method for myocardial protection in distant procurement and preservation of donor hearts in the OCS.
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ISSN:0886-0440
1540-8191
DOI:10.1111/jocs.14162