Superior myocardial preservation with HTK solution over Celsior in rat hearts with prolonged cold ischemia

Lee, Sungsoo; Huang, Chien Sheng; Kawamura, Tomohiro; Shigemura, Norihisa; Stolz, Donna B.; Billiar, Timothy R.; Luketich, James D.; Nakao, Atsunori; Toyoda, Yoshiya

doi:10.1016/j.surg.2010.04.009

Cited by 22 publications

(15 citation statements)

References 24 publications

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“…In a single-center, randomized study comparing CEL and HTK solution in 48 heart transplant recipients (24 patients in each group) [19], the onset of a spontaneous and stable sinus rhythm after reperfusion of the heart allograft was seen more rapidly in the CEL patients than HTK. In contrast, in a trial with 224 patients [18], a trend toward decreased need for inotropic agents after preservation with HTK compared with CEL and University of Wisconsin solution occurred.…”

Section: Commentmentioning

confidence: 89%

“…We tested two commercially available preserva- Accordingly, we examined the protective efficacies of these two low potassium solutions (HTK and CEL) during ischemia and reperfusion using a rat heterotopic heart transplantation model with older donors, and paid special attention to the myocardial content of adenosine triphosphates during and after cold ischemia. Previously, we have shown that HTK provides better cardioprotection than CEL for cold ischemia-reperfusion in mature rat hearts [18]. The purpose of this study was to assess the effect of HTK versus CEL on myocardial protection in aged rat hearts.…”

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confidence: 99%

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Histidine-Tryptophan-Ketoglutarate or Celsior: Which Is More Suitable for Cold Preservation for Cardiac Grafts From Older Donors?

Lee

Huang

Kawamura

et al. 2011

The Annals of Thoracic Surgery

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Background. The growing number of patients awaiting heart transplantation, coupled with the worldwide donor shortage, has led to increased use of marginal organs, specifically hearts from older donors. This study compared the protective effects of two widely used preservation solutions, histidine-tryptophan-ketoglutarate (HTK) and Celsior (CEL; Sangstat Medical, Menlo Park, CA), for ischemia-reperfusion injury using a rat heterotopic heart transplantation model with older donors.Methods. The hearts were excised from 16-and 80-week-old Lewis donor rats, stored in HTK, CEL, or saline for 6 hours and heterotopically transplanted into syngenic young Lewis recipients. Serum troponin I and creatine phosphokinase, graft infiltrating cells, graft apoptosis, graft proinflammatory messenger ribonucleic acid levels, and adenosine monophosphate-activated protein kinase phosphorylation were analyzed 3, 6, and 12 hours after reperfusion as markers of graft injury.

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Section: Commentmentioning

confidence: 89%

mentioning

confidence: 99%

Histidine-Tryptophan-Ketoglutarate or Celsior: Which Is More Suitable for Cold Preservation for Cardiac Grafts From Older Donors?

Lee

Huang

Kawamura

et al. 2011

The Annals of Thoracic Surgery

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“…The limit of these studies, however, is represented by the fact that they have been conducted on animal models and not on humans. 20,21 Pereda and coworkers used Celsior solution as the basis for a blood cardioplegic solution and highlighted its safety and efficacy during aortic valve elective surgery, comparing it to the standard cold blood solution. 22 Celsior and blood cardioplegia are different.…”

Section: Discussionmentioning

confidence: 99%

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

et al. 2013

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Myocardial protection during cardiac surgery can be accomplished by different cardioplegic solutions. The aim of this study was to assess myocardial damage after heart valve surgery performed with myocardial protection of a single dose of Celsior cardioplegia or with repeated cold blood cardioplegia. After the stratification of 139 valvular patients by means of matching according to cross-clamp and cardiopulmonary bypass time, 32 patients were retained for comparison (16 patients received Celsior and 16 patients received cold blood cardioplegia). Creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) release were evaluated until six days after the operation. Pre-operative characteristics were similar in both groups. In the Celsior group, CK-MB and cTnI values were significantly higher from the first up to the sixth post-operative day. Peak cTnI values were 19.4 ± 13.4 and 9.7 ± 7 ng/mL (p=0.01) in the Celsior and the Cold Blood group, respectively. Peak CK-MB values were 79.6 ± 58.8 and 45.9 ± 20.6 U/L (p=0.07) in the Celsior and the Cold Blood group, respectively. Cold blood cardioplegia reduces perioperative myocardial damage compared to the Celsior solution in elective cardiac valve operations.

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“…Lee et al [14], contrariwise, found that Bretschneider-HTK (HTK) solution exhibited superior protective effects over CEL against prolonged cold ischemia in a syngeneic rat transplantation model.…”

Section: Discussionmentioning

confidence: 99%

Estudo comparativo experimental da proteção miocárdica com soluções cristalóides para transplante cardíaco

Lima¹,

Fiorelli²,

Vassallo³

et al. 2012

Rev Bras Cir Cardiovasc

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Estudo comparativo experimental da proteção miocárdica com soluções cristalóides para transplante cardíacoComparative experimental study of myocardial protection with crystalloid solutions for heart transplantation Abstract Background: There is a growing need to improve myocardial protection, which will lead to better performance of cardiac operations and reduce morbidity and mortality. Therefore, the objective of this study was to compare the efficacy of myocardial protection solution using both intracellular and extracellular crystalloid type regarding the performance of the electrical conduction system, left ventricular contractility and edema, after being subjected to ischemic arrest and reperfusion.Methods: Hearts isolated from male Wistar (n=32) rats were prepared using Langendorff method and randomly divided equally into four groups according the cardioprotective solutions used Krebs-Henseleit-Buffer (KHB), Bretschneider-HTK (HTK), St. Thomas-1 (STH-1) and Celsior (CEL). After stabilization with KHB at 37°C, baseline values (control) were collected for heart rate (HR), left ventricle systolic pressure (LVSP), maximum first derivate of rise left ventricular pressure (+dP/dt), maximum first derivate of fall left ventricular pressure (-dP/dt) and coronary flow (CF). The hearts were then perfused at 10°C for 5 min and kept for 2 h in static ischemia at 20°C in each cardioprotective solution. Data evaluation was done using analysis of variance in completely randomized One-Way ANOVA and Tukey's test for multiple comparisons. The level of statistical significance chosen was P<0.05.Results: HR was restored with all the solutions used. The evaluation of left ventricular contractility (LVSP, +dP/ dt and -dP/dt) showed that treatment with CEL solution was better compared to other solutions. When analyzing the CF, the HTK solution showed better protection against edema.Conclusion: Despite the cardioprotective crystalloid solutions studied are not fully able to suppress the deleterious effects of ischemia and reperfusion in the rat heart, the CEL solution had significantly higher results followed by HTK>KHB>STH-1.

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Superior myocardial preservation with HTK solution over Celsior in rat hearts with prolonged cold ischemia

Cited by 22 publications

References 24 publications

Histidine-Tryptophan-Ketoglutarate or Celsior: Which Is More Suitable for Cold Preservation for Cardiac Grafts From Older Donors?

Histidine-Tryptophan-Ketoglutarate or Celsior: Which Is More Suitable for Cold Preservation for Cardiac Grafts From Older Donors?

Myocardial damage following cardiac surgery: comparison between single-dose Celsior cardioplegic solution and cold blood multi-dose cardioplegia

Estudo comparativo experimental da proteção miocárdica com soluções cristalóides para transplante cardíaco

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