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Ann Thorac Surg 2005;80:1812-1820
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Attenuation of DNA Damage in Canine Hearts Preserved by Continuous Hypothermic Perfusion

^a Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
^b Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
^c Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland

Accepted for publication April 25, 2005.

^_* Address correspondence to Dr Conte, Heart and Heart/Lung Transplantation, The Johns Hopkins Medical Institutions, 600 North Wolfe St, Blalock 618, Baltimore, MD 21287 (Email: jconte{at}csurg.jhmi.jhu.edu).

BACKGROUND: Continuous hypothermic perfusion is a novel cardiac preservation technique. Reactive oxygen species play a role in ischemia reperfusion injury and limit organ preservation. Oxidative stress mediates a DNA mismatch lesion (7, 8-dihydro-8-oxoguanine [8-oxo-G]), which is repaired by the enzymes MutY homologue (MYH), 8-oxo-G glycosylase (OGG1), and MutS homologue 2 (MSH2). We hypothesized that continuous hypothermic perfusion would allow for maintenance of cardiac function while attenuating myocardial DNA damage with respect to the current clinical practice of static preservation at 4°C.

METHODS: In our canine orthotopic transplant model, donor hearts were harvested after echocardiograms, and hemodynamic studies were obtained and served as controls. The hearts were transplanted after 24 hours of continuous hypothermic perfusion or 4 hours of static preservation, and were studied for 6 hours. Quantification of 8-oxo-G lesions, MYH, OGG1, and MSH2 concentrations were performed on biopsies using immunohistochemistry.

RESULTS: Postimplant echocardiograms, completed in 7 continuously perfused and 8 statically preserved hearts, demonstrated good function and normal wall motion. Positive staining for 8-oxoG was markedly increased in the static preservation group. Staining density for MYH, OGG1, and MSH2 were significantly decreased in statically preserved hearts and equivalent between continuously perfused and control hearts.

CONCLUSIONS: The DNA damage assayed by 8-oxoG was significantly increased in statically preserved versus continuously perfused hearts. The DNA repair enzymes MYH, OGG1, and MSH2 were also markedly decreased in the static preservation versus continuous hypothermic perfusion groups. Continuous hypothermic perfusion reduces oxidative damage and extends preservation without compromising function.

This article has been cited by other articles:

				M. J. Collins, S. L. Moainie, B. P. Griffith, and R. S. Poston Preserving and evaluating hearts with ex vivo machine perfusion: an avenue to improve early graft performance and expand the donor pool. Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 318 - 325. [Abstract] [Full Text] [PDF]

				L. U. Nwakanma, A. S. Shah, J. V. Conte, and W. A. Baumgartner Heart Transplantation Card. Surg. Adult, January 1, 2008; 3(2008): 1539 - 1578. [Full Text]