Histological analysis of Static Cold Storage vs Hypothermic Machine Perfusion in porcine hearts

Abstract

Heart failure is a growing health issue and a frequent cause of mortality worldwide. Heart transplantation is the current gold standard to treat people that suffer from end-stage heart disease. Even though there has been significant progress in the field of heart transplantation over the last 45 years, there are still important challenges and obstacles facing the field, which limit the application of heart transplantation, including donor organ shortage. In this sense, the optimization of the process is crucial for medical practice. Currently, static cold storage (SCS) is the clinical standard for heart preservation. However, there is a number of factors that can complicate the procedure, including myocardial ischemia injury. On the other hand, hypothermic machine perfusion (HMP) is considered an ideal approach to extend the donor pool and increase the utilization rate. In the present study, we sought to investigate the effects of hypothermic machine perfusion vs static cold storage in slaughterhouse porcine hearts, in order to compare the two preservation strategies and therefore enhance the existing knowledge, regarding the histological changes that happen in these hearts during preservation. In this context, we used apical biopsies from porcine hearts that were preserved for 4 hours with SCS or HMP, and subsequent 4 hours of normothermic reperfusion to evaluate each method. H&E and PTAH staining were performed to assess the myocardial injury and mitochondrial damage. Altogether, this approach could not give us a comprehensive overview of the effect of HMP vs SCS on tissue integrity. Future studies are essential to further elucidate the effects of machine perfusion on porcine hearts.