Background and Aim: The porcine heart bears the best
resemblance to the human heart and remains the preferred preclinical model for
anatomical, physiological, and medical device studies. In an effort to study
phenomena related strictly to ischemia reperfusion and donor preservation
protocols, it is essential to avoid the immune responses related to
allotransplantation. Orthotopic auto-transplantation is a unique strategy to
the field of cardiac transplantation for ex
vivo experimentation. Nevertheless, auto-transplantation carries its own
technical challenges related to insufficient length of the great vessels that
are to be transected and re-anastomosed. Methods: A novel method for orthotopic
cardiac auto-transplantation in the porcine model was developed and was described herein. Porcine models were used for ex vivo experimentation of a novel
device to study ischemia reperfusion injury. Results: A total of five porcine
models were used for ex vivo experimentation of a novel device to mitigate ischemia reperfusion injury and
determine effects of donor preservation.
Modifications to routine cardiac transplantation protocols to allow for
successful auto-transplantation are described. Conclusion: Orthotopic cardiac
auto-transplantation in the porcine model is a plausible and technically
feasible method for reliable study of ischemia reperfusion injury and donor
preservation protocols. Here, we describemethods for
References
[1]
Karimi, A., Cobb, J.A., Staples, E.D., Baz, M.A. and Beaver, T.M. (2011) Technical Pearls for Swine Lung Transplantation. Journal of Surgical Research, 171, e107-e111. https://doi.org/10.1016/j.jss.2011.05.067
[2]
Pierson 3rd, R.N., Dorling, A., Ayares, D., Rees, M.A., Seebach, J.D., Fishman, J.A., et al. (2009) Current Status of Xenotransplantation and Prospects for Clinical Application. Xenotransplantation, 16, 263-280. https://doi.org/10.1111/j.1399-3089.2009.00534.x
[3]
Cooper, D.K., Satyananda, V., Ekser, B., van der Windt, D.J., Hara, H., Ezzelarab, M.B., et al. (2014) Progress in Pig-to-Non-Human Primate Transplantation Models (1998-2013): A Comprehensive Review of the Literature. Xenotransplantation, 21, 397-419. https://doi.org/10.1111/xen.12127
[4]
Iskender, I., Sakamoto, J., Nakajima, D., Lin, H., Chen, M., Kim, H., et al. (2016) Human Alpha1-Antitrypsin Improves Early Post-Transplant Lung Function: Pre-Clinical Studies in a Pig Lung Transplant Model. The Journal of Heart and Lung Transplantation, 35, 913-921. https://doi.org/10.1016/j.healun.2016.03.006
[5]
Griffith, B.P., Goerlich, C.E., Singh, A.K., Rothblatt, M., Lau, C.L., Shah, A., et al. (2022) Genetically Modified Porcine-to-Human Cardiac Xenotransplantation. The New England Journal of Medicine, 387, 35-44. https://doi.org/10.1056/NEJMoa2201422
[6]
Platt, J.L. and Cascalho, M. (2022) The Future of Transplantation. The New England Journal of Medicine, 387, 77-78. https://doi.org/10.1056/NEJMe2207105
(2011) National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals. Guide for the Care and Use of Laboratory Animals. 8th Edition, National Academies Press (US), Washington, DC.
[9]
Crick, S.J., Sheppard, M.N., Ho, S.Y., Gebstein, L. and Anderson, R.H. (1998) Anatomy of the Pig Heart: Comparisons with Normal Human Cardiac Structure. Journal of Anatomy, 193, 105-119. https://doi.org/10.1046/j.1469-7580.1998.19310105.x