Comparison of Experimental Rat Models in Donation after Circulatory Death (DCD): in-situ versus ex-situ Ischemia

Arnold, Maria; Méndez-Carmona, Natalia; Wyss, Rahel K.; Joachimbauer, Anna; Casoni, Daniela; Carrel, Thierry; Longnus, Sarah (2021). Comparison of Experimental Rat Models in Donation after Circulatory Death (DCD): in-situ versus ex-situ Ischemia. Frontiers in cardiovascular medicine, 7 Frontiers 10.3389/fcvm.2020.596883

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Introduction: Donation after circulatory death (DCD) could substantially improve donor heart availability. However, warm ischemia prior to procurement is of particular concern for cardiac graft quality. We describe a rat model of DCD with in-situ ischemia in order to characterize the physiologic changes during the withdrawal period before graft procurement, to determine effects of cardioplegic graft storage, and to evaluate the post-ischemic cardiac recovery in comparison with an established ex-situ ischemia model.
Methods: Following general anesthesia in male, Wistar rats (404±24g, n=25), withdrawal of life-sustaining therapy was simulated by diaphragm transection. Hearts underwent no ischemia or 27 min in-situ ischemia and were explanted. Ex situ, hearts were subjected to a cardioplegic flush and 15 min cold storage or not, and 60 min reperfusion. Cardiac recovery was determined and compared to published results of an entirely ex-situ ischemia model (n=18).
Results: In donors, hearts were subjected to hypoxia and hemodynamic changes, as well as increased levels of circulating catecholamines and free fatty acids prior to circulatory arrest. Post-ischemic contractile recovery was significantly lower in the in-situ ischemia model compared to the ex-situ model, and the addition of cardioplegic storage improved developed pressure-heart rate product, but not cardiac output.
Conclusion: The in-situ model provides insight into conditions to which the heart is exposed before procurement. Compared to an entirely ex-situ ischemia model, hearts of the in-situ model demonstrated a lower post-ischemic functional recovery, potentially due to systemic changes prior to ischemia, which are partially abrogated by cardioplegic graft storage.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Herz- und Gefässchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Herz- und Gefässchirurgie

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR)

UniBE Contributor:

Arnold, Maria Regula; Méndez Carmona, Natalia; Wyss, Rahel Kathrin; Joachimbauer, Anna; Casoni, Daniela; Carrel, Thierry and Henning Longnus, Sarah

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2297-055X

Publisher:

Frontiers

Language:

English

Submitter:

Paul Libera

Date Deposited:

14 Jan 2021 15:34

Last Modified:

14 Jan 2021 15:43

Publisher DOI:

10.3389/fcvm.2020.596883

BORIS DOI:

10.48350/150826

URI:

https://boris.unibe.ch/id/eprint/150826

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