TY - JOUR
T1 - Effect of hyperkalemia and hemolysis caused by hyperacute rejection on cardiac function in pig to human ex vivo xenogeneic cardiac perfusion model
AU - Kim, Jun Seok
AU - Lee, Hak Mo
AU - Oh, Byoung Choi
AU - Lim, Hong Gook
AU - Lee, Jeong Ryul
PY - 2011/3
Y1 - 2011/3
N2 - Background and Objectives: Hyperacute rejection (HAR) is a major obstacle to successful xenotransplantation of vascularized organs. This study was conducted to observe the effect of hemolysis of perfused human whole blood on pig heart function, and determine the major risk factors for preservation of xenoperfused cardiac function using ex-vivo pig to human xenogeneic cardiac perfusion model. Materials and Methods: Harvested pig hearts were perfused with normal human whole blood (group 1), two different types of pre-treated human whole blood (group 2: immunoglobulins were depleted by plasmapheresis, group 3: pre-treated with plasmapheresis, GAS914, cobra venom factor (CVF) and steroid), and normal porcine whole blood as control (group 4) for 3 hours. Results: Duration of heart beat was significantly prolonged in group 2 and group 3. Histological examination showed widespread HAR features but was gradually delayed in groups 2 and 3 compared to group 1. The absolute levels of serum creatine kinase-MB and Troponin I increased gradually, and was lower in group 3. Serum hemoglobin levels were rapidly increased in groups 3 and 4, compared to group 1. Extracellular potassium level increased sharply from the beginning of blood perfusion in groups 1,2 and 3, compared to group 4. Conclusion: Pretreatment of human whole blood, including immunoglobulin depletion, CVF and steroid reduced and delayed the destruction of pig myocardium by HAR. However, the increased extracellular potassium levels in groups 1,2 and 3 reflected that these treatments could not prohibit myocardial injury by HAR.
AB - Background and Objectives: Hyperacute rejection (HAR) is a major obstacle to successful xenotransplantation of vascularized organs. This study was conducted to observe the effect of hemolysis of perfused human whole blood on pig heart function, and determine the major risk factors for preservation of xenoperfused cardiac function using ex-vivo pig to human xenogeneic cardiac perfusion model. Materials and Methods: Harvested pig hearts were perfused with normal human whole blood (group 1), two different types of pre-treated human whole blood (group 2: immunoglobulins were depleted by plasmapheresis, group 3: pre-treated with plasmapheresis, GAS914, cobra venom factor (CVF) and steroid), and normal porcine whole blood as control (group 4) for 3 hours. Results: Duration of heart beat was significantly prolonged in group 2 and group 3. Histological examination showed widespread HAR features but was gradually delayed in groups 2 and 3 compared to group 1. The absolute levels of serum creatine kinase-MB and Troponin I increased gradually, and was lower in group 3. Serum hemoglobin levels were rapidly increased in groups 3 and 4, compared to group 1. Extracellular potassium level increased sharply from the beginning of blood perfusion in groups 1,2 and 3, compared to group 4. Conclusion: Pretreatment of human whole blood, including immunoglobulin depletion, CVF and steroid reduced and delayed the destruction of pig myocardium by HAR. However, the increased extracellular potassium levels in groups 1,2 and 3 reflected that these treatments could not prohibit myocardial injury by HAR.
KW - Extracorporeal circulation
KW - Hemolysis
KW - Heterologous
KW - Hyperkalemia
KW - Transplantation
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U2 - 10.4070/kcj.2011.41.3.130
DO - 10.4070/kcj.2011.41.3.130
M3 - Article
C2 - 21519511
AN - SCOPUS:79955818305
VL - 41
SP - 130
EP - 136
JO - Korean Circulation Journal
JF - Korean Circulation Journal
SN - 1738-5520
IS - 3
ER -