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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vtio</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник трансплантологии и искусственных органов</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Transplantology and Artificial Organs</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-1191</issn><publisher><publisher-name>Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15825/1995-1191-2022-3-111-120</article-id><article-id custom-type="elpub" pub-id-type="custom">vtio-1534</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Донорство органов</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Organ Donation</subject></subj-group></article-categories><title-group><article-title>Результаты исследования эффективности прямой коронарной персуффляции как метода кондиционирования донорского сердца</article-title><trans-title-group xml:lang="en"><trans-title>Results of a study of the effectiveness of direct coronary oxygen persufflation as a donor heart conditioning method</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Жульков</surname><given-names>М. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhulkov</surname><given-names>M. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сирота</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sirota</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зыков</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Zykov</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сабетов</surname><given-names>А. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Sabetov</surname><given-names>A. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Агаева</surname><given-names>Х. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Agaeva</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макаев</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Makaev</surname><given-names>А. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макаев Александр Геннадьевич</p><p>Адрес: 630055, Новосибирск, ул. Речкуновская д. 15Тел. (383) 347-60-66</p></bio><bio xml:lang="en"><p>Alexander Makaev</p><p>Address: 15, Rechkunovskaya str., Novosibirsk, 630055Phone: (383) 347-60-66</p></bio><email xlink:type="simple">makaev_a@meshalkin.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Осинцев</surname><given-names>Д. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Osintsev</surname><given-names>D. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Надеев</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Nadeev</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кливер</surname><given-names>В. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Kliver</surname><given-names>V. Е.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кливер</surname><given-names>Е. Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Kliver</surname><given-names>E. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Волков</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Volkov</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Таркова</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarkova</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фомичев</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Fomichev</surname><given-names>А. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чернявский</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernyavsky</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр имени академика Е.Н. Мешалкина» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Meshalkin National Medical Research Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novosibirsk State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>24</day><month>08</month><year>2022</year></pub-date><volume>24</volume><issue>3</issue><fpage>111</fpage><lpage>120</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Жульков М.О., Сирота Д.А., Зыков И.С., Сабетов А.К., Агаева Х.А., Макаев А.Г., Осинцев Д.М., Надеев А.П., Кливер В.Е., Кливер Е.Э., Волков А.М., Таркова А.Р., Фомичев А.В., Чернявский А.М., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Жульков М.О., Сирота Д.А., Зыков И.С., Сабетов А.К., Агаева Х.А., Макаев А.Г., Осинцев Д.М., Надеев А.П., Кливер В.Е., Кливер Е.Э., Волков А.М., Таркова А.Р., Фомичев А.В., Чернявский А.М.</copyright-holder><copyright-holder xml:lang="en">Zhulkov M.O., Sirota D.A., Zykov I.S., Sabetov A.K., Agaeva K.A., Makaev А.G., Osintsev D.M., Nadeev A.P., Kliver V.Е., Kliver E.E., Volkov A.M., Tarkova A.R., Fomichev А.V., Chernyavsky A.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.transpl.ru/vtio/article/view/1534">https://journal.transpl.ru/vtio/article/view/1534</self-uri><abstract><p>Цель: оценить техническую возможность выполнения, а также функциональную, метаболического и структурную целостность миокарда донорского сердца после 4 часов прямой внутрикоронарной кислородной персуффляции в эксперименте. Материалы и методы. В качестве экспериментальной модели были использованы поросята (mini-pig) сибсы в возрасте 3 месяцев с массой тела 23–36 кг. В контрольной группе (n = 8) фармакохолодовую консервацию донорского сердца выполняли введением в корень аорты 2 литров раствора Bretschneider (Custodiol®, Германия, HTK). В экспериментальной группе (n = 8) для инициации кардиоплегии использовали модифицированный раствор HTK (c добавлением 40 мг/л гиалуронидазы), затем в восходящий отдел аорты нагнетали увлажненный карбоген (95% O2, 5% СО2), поддерживая давление в корне аорты на уровне 40–45 мм рт. ст. Сердца хранили в растворе mHTK при температуре 0–4 °С. По окончании 3 часов консервации донорского сердца выполняли ортотопическую трансплантацию сердца реципиенту. В посттрансплантационном периоде исследовали параметры центральной гемодинамики, потребление миокардом кислорода, уровень маркеров ишемии миокарда (тропонин I, КФК-МВ, ЛДГ), гистологические признаки структурных клеточных повреждений. Результаты. В ходе исследования было выполнено 16 ортотопических трансплантаций сердца. Через 120 минут после восстановления самостоятельной сердечной деятельности уровень сердечного выброса составил 2,99 [4,85; 3,17] л/мин и 2,48 [2,04; 2,92] л/мин (р &gt; 0,05) в контрольной и экспериментальной группах соответственно. Изменения концентрации ЛДГ, тропонина I и лактата в оттекающей из коронарного синуса крови было достоверно выше в раннем реперфузионном периоде, однако статистически значимого отличия между группами выявлено не было (р &gt; 0,05). Потребление миокардом кислорода составило 8,2 [7,35; 9,35] и 7,7 [6,75; 10,12] мл-О2/мин/100 г соответственно в контрольной и экспериментальной группе (р &gt; 0,05). Морфологические исследования также не показали значимых ишемических повреждений миокарда в группе персуффляции по сравнению с контрольной группой. Заключение. В ходе проведенного эксперимента была доказана техническая возможность и безопасность проведения прямой внутрикоронарной кислородной персуффляции в течение 4 часов на этапе кондиционирования донорского сердца ex vivo. При этом, по данным экспериментов, не было обнаружено значимых преимуществ коронарной персуффляции по сравнению со стандартным протоколом фармакохолодовой консервации донорского сердца раствором Bretschneider.</p></abstract><trans-abstract xml:lang="en"><p>Objective: to evaluate the technical feasibility as well as functional, metabolic and structural integrity of donor heart myocardium after 4 hours of direct intracoronary oxygen persufflation in an experiment. Materials and methods. Mini-pig siblings aged 3 months with a body weight of 23–36 kg were used as the experimental model. In the control group (n = 8), donor hearts were cold preserved by injecting 2 liters of Bretschneider cardioplegic solution (Custodiol®, Germany, HTK) into the aortic root. In the experimental group (n = 8), modified HTK solution (with 40 mg/L hyaluronidase added) was used to initiate cardioplegia, then moistened carbogen (95% O2, 5% CO2) was injected into the ascending aorta, maintaining 40–45 mm Hg aortic root pressure. The hearts were stored in an mHTK solution at 0–4 °С. After 3 hours of donor heart preservation, orthotopic heart transplantation (OHTx) was performed. In the post-transplant period, we studied central hemodynamic parameters, myocardial oxygen consumption, level of myocardial ischemia markers (troponin I, TnI; creatine phosphokinase-MB, CPKMB; lactate dehydrogenase, LDH), and histological signs of structural cellular injury. Results. Sixteen OHTx surgeries were performed during the study. At 120 minutes after restoration of spontaneous cardiac activity, cardiac output was 2.99 [4.85; 3.17] L/min and 2.48 [2.04; 2.92] L/min (p &gt; 0.05) in the control and experimental groups, respectively. Changes in LDH, TnI and lactate levels in the blood flowing from the coronary sinus were significantly higher in the early reperfusion period. However, there was no statistically significant difference between the groups (p &gt; 0.05). Myocardial oxygen consumption in the control and experimental groups was 8.2 [7.35; 9.35] ml-O2/min/100 g and 7.7 [6.75; 10.12] ml-O2/min/100 g, respectively (p &gt; 0.05). Morphological examinations also showed no significant myocardial ischemia injury in the persufflation group compared to the control group. Conclusion. The experiment showed the technical feasibility and safety of direct intracoronary oxygen persufflation for 4 hours at the ex vivo donor heart conditioning stage. At the same time, experimental data showed no significant advantages of coronary persufflation over the standard protocol of cold preservation of donor heart with Bretschneider cardioplegic solution.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>кислородная персуффляция</kwd><kwd>консервация сердца</kwd><kwd>терминальная стадия хронической сердечной недостаточности</kwd><kwd>расширенные донорские критерии</kwd><kwd>сердечный выброс</kwd><kwd>трансплантация сердца</kwd><kwd>фармакохолодовая консервация сердца</kwd></kwd-group><kwd-group xml:lang="en"><kwd>oxygen persufflation</kwd><kwd>heart preservation</kwd><kwd>end-stage chronic heart failure</kwd><kwd>expanded donor criteria</kwd><kwd>cardiac output</kwd><kwd>heart transplantation</kwd><kwd>cold heart preservation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Сostanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S et al. 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