Study of re-beating effect after preservation and transplantation of rabbit heart with three different methods of HTK solution

WEI Xue-mei, GUO Yi-long, XU Zhi-xin

Chinese Journal of Clinical Anatomy ›› 2020, Vol. 38 ›› Issue (5) : 583-587.

Chinese Journal of Clinical Anatomy ›› 2020, Vol. 38 ›› Issue (5) : 583-587. DOI: 10.13418/j.issn.1001-165x.2020.05.018

Study of re-beating effect after preservation and transplantation of rabbit heart with three different methods of HTK solution

  • WEI Xue-mei1, GUO Yi-long2, XU Zhi-xin1
Author information +
History +

Abstract

Objective To compare re-beating effect after preservation and transplantation of isolated rabbit heart with simple low temperature immersion, continuous or intermittent perfusion of Histidine-tryptophan-ketoglutarate (HTK) solution. Methods 36 healthy New Zealand rabbits, with 2 months old, with mean weight 2.15 kg , were chosen and divided randomly into the following three groups: a simple low temperature immersion group (simple group, n=10), a continuous group (n=10) and an intermittent 2h perfusion (intermittent group, n=16). The rabbits were taken out the isolated heart after anesthetization to establish HTK solution through aortic root, the hearts were suspended on Langendorff perfusion model. K-H buffer solution was perfused for 5~10 minutes to stable heart pulsation. HTK solution was perfused about 5 ~ 6 ml (30ml/kg) according to the grouping to store heart at 4 ℃ for 8 hours. Then pressure transducer and coronary effluent were collected  Cardiac resuscitation time, the difference of myocardial histomorphology and other related indexes among the three groups were compared. Results The isolated hearts were re-beating successfully in the three groups. The resuscitation time, arrhythmia score after 1 minute and 5 minutes, average heart rate, arrhythmia incidence and time of epinephrine injections in the intermittent group were all significantly lower than those of the continuous group and the simple group (P<0.05). CK-MB and cTnI levels in the intermittent group were less than those of the continuous group and the simple group (P<0.05). The LVSP and CSF values after re-beating 5min in the intermittent group were higher than those of the continuous group and the simple group (P<0.05). The degrees of myocardial cellular edema and inflammatory cell infiltration in the intermittent group were the lowest, but the above indexes in the simple group were the highest. Conclusions Intermittent 2 hours perfusion of HTK solution may be more effective in reducing arrhythmia and myocardial injury, improving left ventricular hemodynamics after cardiac resuscitation in isolated rabbit hearts than continuous perfusion or simple hypothermic immersion, which is expected to be a simple, efficient and safe method for preserving transplanted hearts.

Key words

Histidine-tryptophan-ketoglutarate solution /  Intermittent perfusion /  Transplantation / Re-beating /  Arrhythmia /  Creatine kinase isoenzymes /  Troponin I /  Hemodynamics

Cite this article

Download Citations
WEI Xue-mei, GUO Yi-long, XU Zhi-xin. Study of re-beating effect after preservation and transplantation of rabbit heart with three different methods of HTK solution[J]. Chinese Journal of Clinical Anatomy. 2020, 38(5): 583-587 https://doi.org/10.13418/j.issn.1001-165x.2020.05.018

References

[1]  郑树森, 叶啟发, 李建辉, 等. 中国移植器官保护专家共识(2016版)[J]. 实用器官移植电子杂志, 2017, 5(3): 161-171.
[2]  孟保英, 吴文智, 丁以群, 等. 五种心脏停搏液对未成熟心肌保护效果分析[J]. 中国体外循环杂志, 2017, 15(3): 129-132.
[3]  Schaefer M, Gebhard MM, Gross W. The efficiency of heart protection with HTK or HTK-N depending on the type of ischemia[J]. Bioelectrochemistry, 2019, 125(2): 58-69.
[4]  张洪宇, 庄建. 不同停搏时间下HTK液对幼兔未成熟心肌的保护作用[J]. 中国胸心血管外科临床杂志, 2015, 22(3): 234-240.
[5]  张钟,肖泽周,郭义龙,等. 一氧化碳干燥保存方法对离体小鼠心脏的保护 作用[J]. 广东医学, 2015, 36(4): 497-500. 
[6]  Kirk R, Dipchand AI. Continuous donor perfusion for heart preservation[J]. Progress in Pediatric Cardiology, 2017, 46(5): 154-156.
[7]  韩晓菲, 宋雪银, 徐贯杰. 心脏移植供心保存技术的研究进展[J]. 广东医学, 2015, 36(5): 800-803.
[8]  汪源, 周璞, 周曼玲, 等. HTK液与高钾停搏液在成人心脏手术中心肌保护效果的荟萃分析[J]. 华中科技大学学报(医学版), 2017, 46(4): 484-488.
[9]  郭义龙, 张钟, 周鹏宇, 等. 低温高压一氧化碳(CO)干燥法对离体兔心的保护作用及机制[J]. 首都医科大学学报, 2015, 36(5): 751-756.
[10] 陈波, 曹勇, 冼明海, 等. 改良Del Nido停搏液与改良St.Thomas停搏液在成人联合瓣膜置换术中的心肌保护效果分析[J]. 中国胸心血管外科临床杂志, 2018, 25(1): 58-62.
[11]王嵘, 高长青, 肖苍松, 等. HTK液与含血心脏停搏液对复杂冠状动脉病变合并左心功能不全心肌保护作用的病例对照研究[J]. 中国胸心血管外科临床杂志, 2016, 23(10): 954-959.
[12]Li J, Wu Y, Tian X, et al. Protective effect of HTK solution on postoperative pulmonary function in infants with CHD and PAH[J]. Biosci Rep, 2017, 37(6): 1254-1256. 
[13]Li WC, Gao H, Gao J, et al. Antiarrhythmic effect of sevoflurane as an additive to HTK solution on reperfusion arrhythmias induced by hypothermia and ischaemia is associated with the phosphorylation of connexin 43 at serine 368[J]. BMC Anesthesiol, 2019, 19(1): 5.
[14]Pizano A, Montes FR, Carreño M, et al. Histidine-tryptophan-ketoglutarate solution versus blood cardioplegia in cardiac surgery: a propensity-score matched analysis[J]. Heart Surg Forum, 2018, 21(3): E158-E164.
[15] 李伟超, 高巨, 高鸿, 等. 含七氟醚HTK液对心脏移植离体鼠心电生理的保护机制[J]. 实用医学杂志, 2018, 34(9): 1441-1444.
[16] 丁皓, 李小辉, 郑少忆, 等. 离体心脏病理生理变化的研究进展[J]. 广东医学, 2015, 36(6): 960-962.
[17] 王元祥, 周晓东, 孟保英, 等. 去白细胞冷自体血停搏液减轻婴儿体外循环心脏手术心肌损伤作用的研究[J]. 中国体外循环杂志, 2018, 16(6): 330-333.
[18] 王贵龙, 高鸿, 王子君, 等. 七氟醚对大鼠离体心脏全心缺血-再灌注心律失常及电生理的影响[J]. 临床麻醉学杂志, 2018, 34(12): 1223-1226.
[19]周平, 蒋鑫, 杨小利, 等. 整合素连接激酶对大鼠离体心脏缺血再灌注室性心律失常的影响[J]. 第三军医大学学报, 2014, 36(18): 1872-1875.
[20]Ambrosi P, Kreitmann B, Fromonot J, et al. Plasma ultrasensitive cardiac troponin during long-term follow-up of heart transplant recipients[J]. J Card Fail, 2015, 21(2): 103-107.
[21] 李勇男, 吉冰洋, 高秉仁. 机械灌注保存供体心脏研究进展[J]. 中国分子心脏病学杂志, 2015, 15(6): 1550-1553.
[22] 刘洋, 李攀阳, 张伟华, 等. 离体猪心脏的保存及功能评价[J]. 郑州大学学报(医学版), 2014, 49(6): 845-848.
[23] Monteagudo Vela M, García Sáez D, Simon AR. Current approaches in retrieval and heart preservation[J]. Ann Cardiothorac Surg, 2018, 7(1): 67-74.
[24] Messer S, Ardehali A, Tsui S. Normothermic donor heart perfusion: current clinical experience and the future[J]. Transpl Int, 2015, 28(6): 634-642.

Accesses

Citation

Detail

Sections
Recommended

/