The Suppression of Proinflammatory Cytokines Improves Heart Function From Non-Heart-Beating Donors Following Transplantation in a Canine Model
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概要
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We evaluated the effectiveness of a suppressant of the production of proinflammatory cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)-α on a canine heart transplantation model with non-heart-beating donors (NHBDs).Adult mongrel dogs were divided into 3 groups of 5: a control group; FR-1 in which donors were given FR167653, a potent suppressant of IL-1β and TNF-α production; and FR-2 in which both donors and recipients were given FR167653. After measuring the baseline hemodynamic parameters, including cardiac output (CO), left ventricular pressure (LVP), and maximum and minimum rates of increase in LVP (± LVdp/dt), FR167653 was administered continuously for 30 minutes before ischemia in the FR-1 and FR-2 groups. Cardiac arrest was obtained by rapid exsanguination from the abdominal aorta and inferior vena cava. The organ was left in the cadaver for 30 minutes. The coronary vascular beds were washed out with 4°C Celsior solution, and then the donor heart was preserved in 4°C Celsior solution for 4 hours. The donor heart was transplanted orthotopically with cardiopulmonary bypass (CPB). FR167653 was administered intravenously from 15 minutes before aortic-cross clamping until the end of the experiment in the FR-2 group. The recipient was weaned from CPB 1 hour after reperfusion. We compared the hemodynamic parameters at 3 hours after reperfusion with the preoperative values in donor animals with the right atrial pressure at 10 mmHg and a 5 μg/kg/min dopamine infusion. Histopathological analysis was also performed.There were no significant differences in the recovery rates of the hemodynamic parameters between the control and FR-1 groups and between the FR-1 and FR-2 groups. However, the recovery rates of CO and -LVdp/dt in the FR-2 group were significantly (P < 0.05) higher than those in the control group. Histopathological analysis showed that myofilaments were better preserved in the FR-2 group compared with the control group.The administration of a suppressant of proinflammatory cytokines before both ischemia and reperfusion effectively preserves donor heart function after transplantation with NHBDs.
著者
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Oshima Kiyohiro
Intensive Care Unit Gunma University Hospital
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Ohki Shigeru
Department Of Intensive Care And Second Department Of Surgery Gunma University Graduate School Of Me
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Takeyoshi Izumi
Department Of Thoracic And Visceral Organ Surgery Graduate School Of Medicine Gunma University
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Tsutsumi Hirofumi
Department Of Legal Medicine Nihon University School Of Dentistry
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Koike Norimasa
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
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Tsutsumi Hirofumi
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
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Matsumoto Koshi
CML Pathological Research
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Ohki Shigeru
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine
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