Immunohistochemical analysis to assess the effects of static cold storage versus hypothermic machine perfusion on porcine hearts

Abstract

Background Because of population ageing and a high prevalence of overweight, heart failure is a growing global health issue. Currently heart transplantion (HTx) is the gold standard treatment, but this treatment is paired with a high waiting-list mortality, partially caused by a shortage of donor hearts. One way to increase the donor pool would be to change the preservation of the donor hearts. A novel way to preserve donor hearts is hypothermic machine perfusion. In this study, the effects of the currently used preservation method static, cold storage and hypothermic machine perfusion on slaughterhouse porcine hearts have been compared using immunohistochemical analyses. Methods Slaughterhouse porcine hearts were removed and preserved for 4 hours using either static cold storage (SCS) or hypothermic machine perfusion (HMP) followed by 4 hours of normothermic machine perfusion (NMP). At the end of the experiment, tissue samples were collected and aphosphotungstic acid-haematoxylin (PTAH) staining was used to score contraction band necrosis and erythrocyte extravasation. An active caspase-3 staining was performed to score apoptosis. Results After normalising the data for the survival time of the hearts, The SCS hearts showed significantly higher contraction band necrosis compared to HMP hearts. Conclusion HMP shows great potential to improve the donor pool. In this study we discovered that more contraction band necrosis is present in hearts that are preserved using SCS compared to HMP. Further studies should include a higher sample size and more stainings could be performed to further elucidate the effects of SCS and HMP on porcine hearts