Non heart beating organ donor: new experimental model in pigs

Abstract

PURPOSE:To describe technical aspects of a new experimental model that simulates a non heart beating organ donor. METHODS:Landrace pigs were operated on and cardiac arrest was obtained by means of myocardial infarction and interruption of ventilator support. RESULTS:Mean cardiac frequency, systolic and diastolic blood pressure levels, central venous pressure, oxygen saturation and concentration of expired CO 2 dropout occurred at seven minutes after cardiac arrest. CONCLUSION:The procedure was easily reproduced and a homogeneous circulatory failure could de obtained by the end of seven minutes. The model is suitable for further studies regarding abdominal organ transplantation.Key words: Transplantation. Models, Animal. Experimental Development. Heart Arrest. Swine. RESUMO OBJETIVO:Descrever os aspectos técnicos de um novo modelo experimental que simula um doador de órgãos após a parada cardíaca. MÉTODOS:Suínos da raça Landrace foram operados e a parada cardíaca foi obtida por meio de infarto do miocárdio e interrupção do suporte ventilatório. RESULTADOS:Freqüência cardíaca, pressão arterial sistólica e diastólica, pressão venosa central, saturação de oxigênio e concentração parcial de CO 2 são consistentes com falência hemodinâmica ao final de sete minutos. CONCLUSÕES:O procedimento foi facilmente executado e uma falência circulatória pode ser obtida ao final de sete minutos. Este modelo é adequado para estudos posteriores com respeito a preservação e tranplantes de órgãos abdominais.

The feasibility of an experimental model of donors after cardiac death in remote ischemic preconditioning studies for renal transplantation in porcine

“…This study supports the applicability of the proposed protocol by Morais et al 13 This method has no pharmacological drugs interference, which could compromise graft function by influencing the Na/K transport between membranes, neither the precocious effects of ischemia-reperfusion injury provided by exsanguination described by Schön et al 15 , nor the imprecise analysis of variables and outcomes in the model proposed by Sato et al 16 , once the latter is absent of specification of electrocardiographic criteria and points high variability of time between the withdrawal of life support and cardiac arrest 15,16 . Since no pharmacologic agents or life support withdraw were used in our study with the intent of cardiac arrest, we speculate that organ preservation can be achieved with minimal experimental bias.…”

“…Although a little delay in the remote preconditioning time of death whose mechanisms do not matter to this study, it does not invalidate this model and corroborates the perspectives of Morais et al 13 Only groups 3 and 4 did not show significant statistical difference, nevertheless, their tendencies followed group 2. Considering that there is a lack of standardization of DCD for transplants, this model can be considered a sui parameter for further studies regarding the preservation of organ transplants.…”

“…A homogenous circulatory collapse can be obtained by the end of nine minutes with a small difference of time from the one reported by Morais et al 13 (seven minutes) and with a similar hemodynamic pattern. Although a little delay in the remote preconditioning time of death whose mechanisms do not matter to this study, it does not invalidate this model and corroborates the perspectives of Morais et al 13 Only groups 3 and 4 did not show significant statistical difference, nevertheless, their tendencies followed group 2.…”

“…Our results have shown that the surgical protocol proposed by Morais et al 13 is reproducible, easily performed and applicable to other experimental studies on remote ischemic preconditioning.…”

“…Economic savings might be another benefit to consider, as well as the usefulness of the method on simulating the Maastricht's category IV of DCD 13 .…”