# Use of Antegrade Coronary Oxygen Persufflation as a Strategy for Donor Heart Preservation

## TL;DR

This study tested a new method of preserving donor hearts using oxygen-rich fluid and found it feasible but not better than standard methods.

## Contribution

Demonstrated the technical feasibility of direct coronary oxygen persufflation for donor heart preservation.

## Key findings

- Direct coronary oxygen persufflation was technically feasible for four hours.
- No significant advantages of COP over standard cold preservation were observed.
- No significant myocardial ischemic injury was found in the persufflation group.

## Abstract

To assess the technical feasibility and functional, metabolic, and structural myocardial
integrity of the donor heart after four hours of direct coronary oxygen persufflation
(COP).

This research was carried out on three-month-old minipig siblings weighing 23-36 kg. Cardiac
arrest was achieved by administrating two liters of Bretschneider’s cardioplegic solution
(histidine-tryptophan-ketoglutarate [HTK]) (Custodiol®, Germany) into the
aortic root. Orthotopic heart transplantation was performed after three hours of cardiac
arrest.

A statistically significant decrease in cardiac output was observed in both groups (from
3.36 ± 0.36 l/min and 3.72 ± 0.52 l/min in the HTK group and modified HTK + COP
to 2.35 ± 0.52 l/min and 2.15 ± 0.34 l/min, respectively)
(Р<0.05). Differences between both groups were insignificant
(P>0.05). Cardiac output was 2.99 ± 0.45 l/min and 2.48 ±
0.58 l/min (Р>0.05) in both groups after 120 min of cardiac recovery.
Lactate dehydrogenase, creatine phosphokinase-MB, and troponin I changes in coronary sinus
blood were significantly higher in the early reperfusion period. Statistical insignificance
was observed between both groups (P>0.05). Myocardial oxygen consumption
was 8.2 [7.35; 9.35] ml-О2/min/100 g and 7.7 [6.75; 10.12]
ml-О2/min/100g in both groups (P>0.05). Histological
examinations demonstrate no significant myocardial ischemic injury in the persufflation
group.

The study demonstrated technical feasibility and safety of direct coronary persufflation for
four hours during ex vivo donor heart conditioning. However, no significant advantages of
direct COP were observed over the standard cold preservation protocol.