Normothermic Ex Vivo Heart Perfusion with Mesenchymal Stem Cell-Derived Conditioned Medium Improves Myocardial Tissue Protection in Rat Donation after Circulatory Death Hearts

Abstract

Objective. Adopting hearts from donation after circulatory death (DCD) is a promising approach to enlarge the donor pool. Nevertheless, DCD hearts experience severe warm ischemia/reperfusion (I/R) injury. Recent studies have demonstrated that conditioned medium (CM) derived from bone marrow mesenchymal stem cells (BMSCs) has the potential of reducing organ I/R injury. Therefore, we investigated whether DCD heart preservation with normothermic ex vivo heart perfusion (EVHP) and BMSCs-CM treatment could alleviate myocardial warm I/R injury in the DCD hearts. Methods. We randomly divided donor rats into two groups: (1) DCD-Control group and (2) DCD-CM group. Before DCD heart preservation with the normothermic EVHP system for 105 minutes, rats suffered from a 25-minute warm ischemia injury in the DCD procedure. Vehicle or CM (300 μl) was added to the perfusate at the beginning of the perfusion process. The cardiac function of DCD hearts in the DCD-Control and DCD-CM groups was measured every 30 minutes. Besides, non-DCD hearts were harvested from the beating-heart rats. Results. The antibody array demonstrated that the CM contained 14 bioactive factors involved in apoptosis, inflammation, and oxidative stress. Warm ischemia injury resulted in a significant increase in the level of oxidative stress, inflammation, and apoptosis in the DCD hearts of DCD-Control group. Furthermore, compared with the DCD-Control group, CM treatment increased the developed pressure, dP / d t max and dP / d t min of the left ventricular in the DCD hearts during a 90-minute EVHP. Moreover, the administration of CM attenuated the level of oxidative stress, inflammation, and apoptosis in the DCD hearts of the DCD-CM group. Conclusions. Normothermic EVHP combined with CM treatment can alleviate warm I/R injury in the DCD hearts by decreasing the level of oxidative stress, inflammatory response, and apoptosis, which might alleviate the shortage of donor hearts by adopting DCD hearts.

Mesenchymal Stem Cells and Extracellular Vesicles: Therapeutic Potential in Organ Transplantation

“…Machine perfusion provides a unique platform for selective direct injection of these MSCs directly into donor organs, overcoming homing, trafficking, and safety issues [10,20]. Recent studies by Zeng et al [28] have shown that normothermic ex vivo heart perfusion combined with bone marrow MSCs derived conditioned medium therapy can attenuate myocardial IRI for DCD heart by reducing levels of oxidative stress, inflammatory response, and apoptosis [28]. IRI is often accompanied by local or systemic inflammatory responses called "aseptic inflammation" or "damagerelated pattern molecules (DAMPs)" to distinguish them from the inflammatory response to infection.…”

Peripheral nerve injury: molecular pathophysiology and prospects for restorative treatment by means of cell transplantation: a literature review

“…Багатогранний позитивний ефект МСК пов'язують із патотропним хомінгом [97], явищем нейрогенного транс диференціювання [90,[97][98][99], зокрема в нейролемоцити [100][101][102], здатністю до злиття з клітинами реципієнта [103], мікровезикулярним [104][105][106][107][108], факторним [97,[100][101][102] чи контактним [97,105] впливом. Крім того, трансплантовані МСК мають імуносупресивну і, ймовірно, локальну протизапальну дію [109][110][111][112].…”