vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2023-4-150-159vtio-1702Research ArticleДонорство органовOrgan DonationНормотермическая аутоперфузия сердечно‑легочного комплекса ex vivo: оценка функционального статуса и метаболизмаNormothermic ex vivo heart and lung autoperfusion: assessment of functional status and metabolismТарковаА. Р.TarkovaA. R.

Новосибирск

Novosibirsk

a_tarkova@meshalkin.ruЗыковИ. С.ZykovI. S.

Новосибирск

Novosibirsk

i_zykov@meshalkin.ruЖульковМ. О.ZhulkovM. O.

Новосибирск

Novosibirsk

medicus-maligna@mail.ruПротопоповА. В.ProtopopovA. V.

Новосибирск

Novosibirsk

andrew-uss@yandex.ruСмирновЯ. М.SmirnovYa. M.

Новосибирск

Novosibirsk

y.smirnov@g.nsu.ruМакаевА. Г.MakaevA.  G.

Макаев Александр Геннадьевич

630055, Новосибирск, ул. Речкуновская, д. 15.

Тел. (905) 198-33-31

Alexander Makaev

15, Rechkunovskaya str., Novosibirsk, 630055

Phone: (905) 198-33-31

sashamakaev@mail.ruГусеваА. В.GusevaA. V.

Новосибирск

Novosibirsk

gusevaanastasya@mail.ruКосимовФ. Ю.KosimovF. Yu.

Новосибирск

Novosibirsk

Kosimov-us@mail.ruМуртазалиевМ. Н.MurtazalievM. N.

Новосибирск

Novosibirsk

murtazaliev_m@meshalkin.ruЛиманскийА. Д.LimanskyA. D.

Новосибирск

 

Novosibirsk

a.limanskii@g.nsu.ruСиротаД. А.SirotaD. A.

Новосибирск

Novosibirsk

d_sirota@meshalkin.ruКливерЕ. Э.KliverE.  E.

Новосибирск

Novosibirsk

ee_kliver@meshalkin.ruКливерВ. Е.KliverV. E. 

Новосибирск

Novosibirsk

v.strelec.96@yandex.ruВолковА. М.VolkovА. M.

Новосибирск

Novosibirsk

a_volkov@meshalkin.ruЧернявскийА. М.ChernyavskyA. M.

Новосибирск

Novosibirsk

amchern@mail.ruФГБУ «Национальный медицинский исследовательский центр имени академика Е.Н. Мешалкина» Минздрава РоссииРоссияMeshalkin National Medical Research CenterRussian FederationИнститут медицины и психологии В. Зельмана Новосибирского государственного университетаРоссияNovosibirsk State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр имени академика Е.Н. Мешалкина» Минздрава России, Новосибирск, Российская Федерация.РоссияMeshalkin National Medical Research CenterRussian FederationФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава РоссииРоссияNovosibirsk State Medical UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр имени академика Е.Н. Мешалкина» Минздрава России; Институт медицины и психологии В. Зельмана Новосибирского государственного университетаРоссияMeshalkin National Medical Research Center; Novosibirsk State UniversityRussian FederationФГБУ «Национальный медицинский исследовательский центр имени академика Е.Н. Мешалкина» Минздрава России; ФГБОУ ВО «Новосибирский государственный медицинский университет» Минздрава РоссииРоссияMeshalkin National Medical Research Center; Novosibirsk State Medical UniversityRussian FederationФГБОУ ВО «Новосибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияMeshalkin National Medical Research CenterRussian Federation202302112023254150159Copyright © Таркова А.Р., Зыков И.С., Жульков М.О., Протопопов А.В., Смирнов Я.М., Макаев А.Г., Гусева А.В., Косимов Ф.Ю., Муртазалиев М.Н., Лиманский А.Д., Сирота Д.А., Кливер Е.Э., Кливер В.Е., Волков А.М., Чернявский А.М., 20242024Таркова А.Р., Зыков И.С., Жульков М.О., Протопопов А.В., Смирнов Я.М., Макаев А.Г., Гусева А.В., Косимов Ф.Ю., Муртазалиев М.Н., Лиманский А.Д., Сирота Д.А., Кливер Е.Э., Кливер В.Е., Волков А.М., Чернявский А.М.Tarkova A.R., Zykov I.S., Zhulkov M.O., Protopopov A.V., Smirnov Y.M., Makaev A.G., Guseva A.V., Kosimov F.Y., Murtazaliev M.N., Limansky A.D., Sirota D.A., Kliver E.E., Kliver V.E., Volkov А.M., Chernyavsky A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1702Цель

Цель: провести сравнительное исследование эффективности 6-часовой нормотермической аутоперфузии сердечного трансплантата ex vivo и фармакохолодовой консервации раствором Bretschneider (Custodiol®, Германия).

Материалы и методы

Материалы и методы. В качестве модели для проведения серии острых экспериментов были использованы свиньи породы ландрас весом 50 ± 5 кг в возрасте 4–5 месяцев (n = 10). В экспериментальной группе (n = 5) кондиционирование сердечно-легочного комплекса проводили методом аутоперфузии в течение 6 часов. В контрольной группе восстановление насосной функции сердца выполняли после 6-часовой фармакохолодовой консервации раствором Bretschneider. Оценку эффективности консервации трансплантата проводили путем измерения параметров гемодинамики, сократительной функции миокарда, потребления миокардом кислорода.

Результаты

Результаты. После реперфузии и повторной изоляции работающего сердечно-легочного комплекса сердечный выброс составил 0,63 [0,37; 0,8] л/мин и 0,37 [0,23; 0,37] л/мин в экспериментальной и контрольной группах соответственно (р < 0,05). Показатели – глобальная ударная работа левого желудочка и рекрутируемая преднагрузкой ударная работа сердца – были значительно выше в экспериментальной группе (р < 0,05).

Заключение

Заключение. В ходе проведенного исследования было показано значительное преимущество нормотермической аутоперфузии в сохранении морфофункционального статуса донорского сердца по сравнению со статической фармакохолодовой консервацией раствором Bretschneider в течение 6 часов.

Objective

Objective: to carry out a comparative study of the efficacy of a 6-hour normothermic ex vivo heart and lung autoperfusion and cold cardioplegia using Bretschneider’s solution (Custodiol®, Germany).

Materials and methods

Materials and methods. Landrace pigs weighing 50 ± 5 kg at the age of 4–5 months (n = 10) were used as a model for a series of acute experiments. In the experimental group (n = 5), the cardiopulmonary complex was conditioned by autoperfusion for 6 hours. In the control group, the heart pumping function was restored after 6-hour cold cardioplegia using Bretschneider’s solution. The efficiency of graft preservation was assessed by measuring hemodynamic parameters, myocardial contractile function, and myocardial oxygen consumption.

Results

Results. After reperfusion and repeated isolation of the working cardiopulmonary complex, cardiac output was 0.63 [0.37; 0.8] L/min and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (p < 0.05). Indicators – global left ventricular stroke work index and preload recruitable stroke work – were significantly higher in the experimental group (p < 0.05).

Conclusion

Conclusion. Normothermic autoperfusion is significantly more effective in preserving the morphofunctional status of a donor heart than static cold storage with Bretschneider solution for 6 hours.

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The authors declare that there are no conflicts of interest present.