Evidence map›Paper›PMID 40053687›Full record

ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2025

Brief hypothermic oxygenated perfusion provides cardioprotection in a pig model of donation after circulatory death.

Manuel Egle, Adrian Segiser, Alexia Clavier, Georgia Beer, Anja Helmer, Rahel Ottersberg, Selianne Graf, Maria Arnold, Fabio Zulauf, Deborah Lagger and 6 more

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Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

16 authors.

Manuel EgleDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0009-0000-6368-7397
Adrian SegiserDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Alexia ClavierDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Georgia BeerDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Anja HelmerDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Rahel OttersbergDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Selianne GrafDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Maria ArnoldDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0003-4146-404X
Fabio ZulaufDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Deborah LaggerDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Maris BartkevicsDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Alexander KadnerDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Daja KrummenacherMagnetic Resonance Methodology Group, Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland.
Peter VermathenMagnetic Resonance Methodology Group, Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland.
Matthias SiepeDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0003-3305-9343
Sarah LongnusDepartment of Cardiac Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0001-8489-917X

Funding

Swiss Heart Foundation FF20086
6 · The paper itself

Abstract

objectivesDonation after circulatory death provides excellent patient outcomes in heart transplantation; however, warm ischaemic graft damage remains a concern. We have reported that a brief period of hypothermic oxygenated perfusion prior to normothermic reperfusion improves graft recovery in a rat model. Here, we investigated the cardioprotective benefits and mechanisms of this approach compared to the current clinical standard in a large animal model.

methodsCirculatory death was induced in anaesthetized male Schweizer Edelschwein pigs (55 kg). Hearts underwent 20 min of warm, in-situ ischaemia, followed by a cold coronary flush and explantation. After 15 min backtable preparation, hearts underwent either 15 min cold static storage (control) or 30 min hypothermic oxygenated perfusion. All hearts were perfused ex vivo under normothermic conditions; 3 h in an unloaded mode, followed by 1 h with left ventricular loading to assess cardiac recovery.

resultsCompared to control conditions (n = 5), hypothermic oxygenated perfusion (n = 5) increased recovery of left ventricular function (cardiac output and maximum relaxation rate, P < 0.001 for both) and decreased cell death marker release (heart-type fatty acid binding protein, P = 0.009 and myoglobin, P < 0.001). In parallel, hypothermic oxygenated perfusion reduced the release of succinate and the oxidative stress marker 8-hydroxy-2'-deoxyguanosine.

conclusionsA brief period of hypothermic oxygenated perfusion, applied as a reperfusion therapy between graft procurement and normothermic machine perfusion, provides cardioprotection in a porcine model of donation after circulatory death. Hypothermic oxygenated perfusion is a promising, easily applicable, cardioprotective reperfusion strategy; this study provides key evidence to support clinical translation.

Indexed as

Heart TransplantationHypothermia, InducedOrgan PreservationPerfusionAnimalsDisease Models, AnimalMaleOxygenSwineOxygenDonation after circulatory deathEx vivo/Ex-situ heart perfusionHeart failureHeart transplantationHypothermic oxygenated perfusionNormothermic machine perfusion

Identifiers

PMID40053687
PMCPMC11919451

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.