Novel vs clinical organ preservation solutions: improved cardiac mitochondrial protection

Background

Heart transplantation remains the gold standard for end-stage heart failure, with current ex vivo organ storage times limited to 4 to 6 h before critical tissue damage occurs. Many preservation solutions exist in an attempt to limit both ischemic and reperfusion damage. In order to compare the effects of various storage solutions, mitochondrial function can be used to provide a sensitive analysis of cellular metabolic function.

Methods

Experimental plates were seeded with cardiac myoblasts and kept in suspended animation for either 4 or 8 h at either 4^o or 21 °C, in Celsior®, Perfadex®, or Somah storage solutions. Cells were then reanimated for 1 h at 37 °C to simulate a reperfusion or clinical transplant scenario. Cellular bioenergetics were measured immediately thereafter to examine biochemical differences between preservation solutions and their effectiveness on preserving metabolic function.

Results

The oxygen consumption rates of Somah solution were significantly higher than Celsior® and Perfadex® at 4 °C, with the exception of Perfadex® at 4^o for 4 h. This effect was sustained up to 8 h. At 21 °C, oxygen consumption rates of Somah solution are significantly higher than Celsior® and Perfadex® at basal conditions after 4 h, but this effect is not sustained after 8 h.

Conclusions

The purpose of this experiment was to study the efficacy of various preservation solutions on a mitochondrial level. The significantly higher oxygen consumption rates of Somah at 4 °C suggests that Somah solution may have the ability to protect cellular mitochondrial integrity, improve transplanted organ function by reducing ischemic-reperfusion injury, and thereby improve transplant outcomes. Given that Somah offers benefits over Celsior® and Perfadex® at 4 °C, it should be a target in future organ preservation solution research.

Electronic supplementary material

The online version of this article (doi:10.1186/s13019-017-0564-x) contains supplementary material, which is available to authorized users.

Procurement of lungs from brain-dead donors

Lung transplantation is the procedure of choice in many patients with end-stage lung disease and is being performed more frequently around the world. However, there continues to be shortage of donor organs with the ever-expanding number of recipients on the waiting list, leading to liberalization of the lung donor selection criteria with increasing acceptance of marginal donors while striving for excellent results. This has placed an increasing emphasis on the technique of donor lung procurement and preservation from marginal donors. Good judgment and procurement techniques are necessary to obtain high-quality donor lungs for transplantation and optimize long-term results. This is a review of our current technique used for the procurement of the lungs from brain-dead donors.