Thorac Cardiovasc Surg 2022; 70(S 01): S1-S61
DOI: 10.1055/s-0042-1742876
Oral and Short Presentations
Monday, February 21
Basic Science in Transplantation

The Use of a Cytokine Adsorber during Machine Perfusion of Donor Hearts Preserves the Coronary Microvascular Function

L. Saemann
1   Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
,
F. Hoorn
2   Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Deutschland
,
A. I. Georgevici
1   Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
,
S. Korkmaz-Icöz
2   Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Deutschland
,
G. Veres
1   Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
,
M. Karck
2   Department of Cardiac Surgery, University Hospital of Heidelberg, Heidelberg, Deutschland
,
A. Simm
1   Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
,
F. Wenzel
3   Hochschule Furtwangen, Fakultät Medical and Life Sciences, Villingen-Schwenningen, Deutschland
,
G. Szabó
1   Department of Cardiac Surgery, University Hospital Halle, Halle (Saale), Deutschland
› Author Affiliations
 

    Background: Microvascular dysfunction (MVD) in cardiac allografts is associated with death, graft failure, or allograft vasculopathy after heart transplantation. Ischemia/reperfusion injury and proinflammatory mediators promote MVD. Proinflammatory mediators are elevated in the blood of organ donors. Machine perfusion (MP) of donor hearts with blood that has been collected from the organ donor is a novel preservation method. Therefore, we investigated the effect of a cytokine adsorber during blood perfusion of hearts to reduce MVD and preserve the microvascular endothelium.

    Method: In a pig model, hearts were harvested and maintained for 4 hours by MP with blood with (w CytoA, N = 5) or without (w/o CytoA, N = 5) an integrated cytokine adsorber. Microvascular blood flow (LDP) was measured for 60 minutes by Laser-Doppler-Perfusion Technology with a balloon-induced left ventricular preload. In a third group (Control, N = 5), LDP was measured immediately after harvesting. We performed immunohistochemical staining of cell adhesion molecules ICAM, VCAM, PECAM, and eNOS. Additionally, we profiled the gene expression from left ventricular tissue samples. We analyzed the correlative relation of expressed genes after preselection by machine learning using the Boruta method.

    Results: Relative LDP (rLDP) was significantly improved in the wCytoA-group (1.27 ± 0.07 vs. 0.78 ± 0.04; p < 0.001) compared with w/o CytoA. The expression of endothelial viability marker eNOS majorly increased, and the expression of endothelial injury markers ICAM, VCAM, and PECAM majorly decreased in the wCytoA group, compared with w/o CytoA. The control group showed a centralized gene cluster. We found a fragmented gene network with heterogeneous gene correlation in the w/o CytoA-group. Use of a cytokine adsorber reconstituted major cluster regions of correlation. Three genes were discovered to allow clear differentiation between groups: HIF1A, CAV1, and FDF2.

    Conclusion: Use of a cytokine adsorption device during MP of donor hearts with blood counteracts preload-dependent MVD, protects the microvascular endothelium by downregulation of adhesion molecules, and partially reconstitutes regulation and correlation of genes.


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    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    03 February 2022

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