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10.1111/ajt.16987
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Título: | Critical warm ischemia time point for cardiac donation after circulatory death |
Fecha de publicación: | may-2022 |
Cita bibliográfica: | American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons |
Palabras clave: | Cardiac contractility Cardiac procurement Donation after circulatory death Normothermic regional perfusion |
Resumen: | Donation after circulatory death (DCD) represents a promising opportunity to overcome the relative shortage of donors for heart transplantation. However, the necessary period of warm ischemia is a concern. This study aims to determine the critical warm ischemia time based on in vivo biochemical changes. Sixteen DCD non-cardiac donors, without cardiovascular disease, underwent serial endomyocardial biopsies immediately before withdrawal of life-sustaining therapy (WLST), at circulatory arrest (CA) and every 2 min thereafter. Samples were processed into representative pools to assess calcium homeostasis, mitochondrial function and cellular viability. Compared to baseline, no significant deterioration was observed in any studied parameter at the time of CA (median: 9 min; IQR: 7–13 min; range: 4–19 min). Ten min after CA, phosphorylation of cAMP-dependent protein kinase-A on Thr197 and SERCA2 decreased markedly; and parallelly, mitochondrial complex II and IV activities decreased, and caspase 3/7 activity raised significantly. These results did not differ when donors with higher WLST to CA times (≥9 min) were analyzed separately. In human cardiomyocytes, the period from WLST to CA and the first 10 min after CA were not associated with a significant compromise in cellular function or viability. These findings may help to incorporate DCD into heart transplant programs. |
Autor/es principal/es: | Sanchez Camara, Silvia Asensio Lopez, Maria del Carmen Royo Villanova, Mario Soler, Fernando Jara Rubio, Ruben Garrido Peñalver, Jose F Pinar, Eduardo Hernandez Vicente, Alvaro Hurtado, Jose A Lax Pérez, Antonio Manuel Pascual Figal, Domingo A. |
Facultad/Departamentos/Servicios: | Facultades, Departamentos, Servicios y Escuelas::Departamentos de la UMU::Medicina |
URI: | http://hdl.handle.net/10201/137488 |
DOI: | 10.1111/ajt.16987 |
Tipo de documento: | info:eu-repo/semantics/article |
Número páginas / Extensión: | 8 |
Derechos: | info:eu-repo/semantics/openAccess Attribution-NonCommercial-NoDerivatives 4.0 Internacional |
Descripción: | ©2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published, version of a Published Work that appeared in final form in American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons. To access the final edited and published work see https://doi.org/10.1111/ajt.16987 |
Aparece en las colecciones: | Artículos: Medicina |
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Fichero | Descripción | Tamaño | Formato | |
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AJT-22-1321.pdf | 2,2 MB | Adobe PDF | ![]() Visualizar/Abrir |
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