Influence of ischemic time on hyperacute xenograft rejection of pig hearts in a working heart perfusion model with human blood

Oxidative stress implication in a new ex-vivo cardiac concordant xenotransplantation model

Xenotransplantation (XT) reveals a growing interest for the treatment of cardiomyopathy. The major barrier is an acute vascular rejection due to an acute humoral rejection. This pathogenesis is a difficult issue and in order to elaborate means for its prevention, we analysed the implication of oxidative stress (OS) on hearts from mini-pigs followed by reperfusion with either autologous or human blood in an attempt to simulate xenotransplantation. About 14 hearts were studied after a Langendorff blood reperfusion: allografts with autologous blood (n = 7) or xenografts with human blood (n = 7). Blood samples were drawn from the coronary sinus to assess ischemia and OS. In xenografts, arrhythmias occurred more frequently (p < 0.01, left ventricular systolic pressure decreased more significantly (p < 0.05), thiobarbituric acid-reactive substances concentrations increased at 30 min (0.7 +/- 0.1 vs. 2.4 +/- 0.3 mmol/l; p < 0.05) while vitamin A levels decreased (p < 0.05). XT was associated with a significant increase in ischemic injury and OS production. OS might play an eminent role in hyperacute humoral rejection.

Singlet oxygen energy illumination during moderate cold ischemia prolongs the survival of concordant hamster xeno-heart transplants

INTRODUCTION

Singlet oxygen energy (SOE) is a potent inhibitor of reactive oxygen species (ROS) in vitro and in vivo in certain dose ranges and can improve the levels of high-energy phosphates (HEP) in concordant hamster xeno-heart transplants. Some data indicate that a certain degree of cold ischemia (CI) might be beneficial to xenotransplants. We investigated if SOE illumination of hamster xeno-hearts during moderate cold ischemia (CI) improved graft survival.

MATERIALS AND METHODS

Eighteen hearts from Golden Syrian hamsters (70 to 80 g) were subjected to 8 hours of CI in cold (+4 degrees C) saline solution (NaCL, 0.9%) before heterotopic cervical transplantation to Lewis rats (220 g). Among the treatment group (n = 8), SOE was produced by illuminating the hearts for 10 minutes every 30 minutes with photons at lambda 634 nm with the Oxylight equipment. Graft function was evaluated every 6 hours after transplantation with digital exam until cessation of heart beats.

RESULTS

The graft survival of SOE-illuminated ischemic hamster xenografts was 2.34 +/- 0.56 versus 1.15 +/- 0.37 days in the control group (P < .05). All hearts displayed immediate graft function versus 70% in the controls (NS).

CONCLUSIONS

SOE illumination at lambda 634 nm during moderate cold ischemia (+4 degrees C) can improve the survival of concordant hamster xeno-heart transplants. The exact mechanism(s) are currently unknown, but the effect might in part be exerted by a combination of reduced production of ROS and increased oxidative phosphorylation.