Endothelial damage during myocardial preservation and storage

Endothelial Dysfunction After Long-term Cold Storage in HTK Organ Preservation Solutions: Effects of Iron Chelators and N-α-acetyl-l-histidine

“…Several pathways of oxidative stress have been implicated in the pathophysiology of severe damage of endothelial cells during cold ischemic storage and after reperfusion. [5][6][7]21 Recent studies have shown the presence of a specific coldinduced oxidative injury that is mediated by ROS formed in an iron-dependent manner. 10 Similar oxidative damage has been documented in various cells cultured in histidine-containing solutions (such as HTK), described as histidine-induced injury, 13 and also appears to be mediated by iron-dependent production of free oxygen radicals.…”

“…[2][3][4] During cardiac transplantation surgery, exposure of the coronary arteries to cardioplegic/organ preservation solutions, cold ischemia and reperfusion causes injury to the coronary endothelium, [5][6][7][8] leading to an enhanced rate of complications and unfavorable outcome (e.g., coronary vasospasm or graft coronary vasculopathy).…”

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

“…Although this has not been studied, the profound physiological derangements (35) associated with brain death such as labile blood pressure, elevated catecholamines and release of cytokines could influence the development of CAV through ischemia-induced endothelial injury (11,36). However using qualitative angiography, Luckraz et al (37) found that the During cardiac transplantation, donor hearts undergo a four-step sequence of cardioplegic arrest, cold storage (preservation), further ischemia during implantation (when temperature control is less certain) and reperfusion; myocardial and endothelial injury can occur at any stage in this process (8,41). Methods for preservation and storage, developed initially to protect cardiomyocyte function, may be deleterious for vascular endothelium.…”

Myocardial and endothelial protection for heart transplantation in the new millenium: lessons learned and future directions

“…In addition, it has been shown that the endothelium is critical not only in maintaining early graft function but may also play a role in late events (e.g., graft rejection and allograft vasculopathy). 24 It has been shown that damaged hearts exhibit loss of endothelium-dependent factors and reduced nitric oxide formation, 25 which results in peri-operative vasospasm, adherence of platelets and leukocyte attachment that causes capillary obstruction with inhomogeneous flow. A comprehensive review on endothelial damage during myocardial preservation and storage was done by Parolari and co-workers.…”