000029731 001__ 29731
000029731 005__ 20131002114011.0
000029731 0248_ $$aoai:doc.rero.ch:20120906133645-OG$$punifr$$ppostprint$$prero_explore$$zcdu34$$zthesis_urn$$zreport$$zthesis$$zcdu61$$zbook$$zjournal$$zcdu16$$zpreprint$$zcdu1$$zdissertation
000029731 041__ $$aeng
000029731 080__ $$a61
000029731 100__ $$aDornbierer, Monika$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland
000029731 245__ $$9eng$$aEarly reperfusion hemodynamics predict recovery in rat hearts: a potential approach towards evaluating cardiac grafts from non-heart-beating donors
000029731 269__ $$c2012-08-21
000029731 520__ $$9eng$$aAims: Cardiac grafts from non-heartbeating donors (NHBDs) could significantly increase organ availability and reduce waiting-list mortality. Reluctance to exploit hearts from NHBDs arises from obligatory delays in procurement leading to periods of warm ischemia and possible subsequent contractile dysfunction. Means for early prediction of graft suitability prior to transplantation are thus required for development of heart transplantation programs with NHBDs.Methods and Results: Hearts (n = 31) isolated from male Wistar rats were perfused with modified Krebs-Henseleit buffer aerobically for 20 min, followed by global, no-flow ischemia (32°C) for 30, 50, 55 or 60 min. Reperfusion was unloaded for 20 min, and then loaded, in working-mode, for 40 min. Left ventricular (LV) pressure was monitored using a micro-tip pressure catheter introduced via the mitral valve. Several hemodynamic parameters measured during early, unloaded reperfusion correlated significantly with LV work after 60 min reperfusion (p<0.001). Coronary flow and the production of lactate and lactate dehydrogenase (LDH) also correlated significantly with outcomes after 60 min reperfusion (p<0.05). Based on early reperfusion hemodynamic measures, a composite, weighted predictive parameter, incorporating heart rate (HR), developed pressure (DP) and end-diastolic pressure, was generated and evaluated against the HR-DP product after 60 min of reperfusion. Effective discriminating ability for this novel parameter was observed for four HR*DP cut-off values, particularly for ≥20 *103 mmHg*beats*min−1 (p<0.01).Conclusion: Upon reperfusion of a NHBD heart, early evaluation, at the time of organ procurement, of cardiac hemodynamic parameters, as well as easily accessible markers of metabolism and necrosis seem to accurately predict subsequent contractile recovery and could thus potentially be of use in guiding the decision of accepting the ischemic heart for transplantation.
000029731 700__ $$aStadelmann, Mathieu$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland - Cardiology, University & Hospital, Fribourg, Switzerland
000029731 700__ $$aSourdon, Joevin$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland - University of Auvergne, Institute of Technology, Clermont-Ferrand, France
000029731 700__ $$aGahl, Brigitta$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland
000029731 700__ $$aCook, Stéphane$$uCardiology, University & Hospital, Fribourg, Switzerland
000029731 700__ $$aCarrel, Thierry P.$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland
000029731 700__ $$aTevaearai, Hendrik T.$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland
000029731 700__ $$aLongnus, Sarah L.$$uDepartment of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland
000029731 773__ $$g2012/7/8/e43642$$tPLoS ONE
000029731 775__ $$gPublished version$$ohttp://dx.doi.org/10.1371/journal.pone.0043642
000029731 8564_ $$fcoo_erd.pdf$$qapplication/pdf$$s598520$$uhttp://doc.rero.ch/record/29731/files/coo_erd.pdf$$yorder:1$$zpdf
000029731 918__ $$aFaculté des sciences$$bDécanat, Ch. du Musée 6A, 1700 Fribourg$$cMédecine
000029731 919__ $$aUniversité de Fribourg$$bFribourg$$ddoc.support@rero.ch
000029731 980__ $$aPOSTPRINT$$bUNIFR$$fART_JOURNAL
000029731 990__ $$a20120906133645-OG