2026-04-29T04:09:22Zhttps://repisalud.isciii.es/rest/oai/request

oai:repisalud.isciii.es:20.500.12105/156332024-09-27T09:44:58Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Sánchez-Cámara, Silvia author Asensio-López, Mari C author Royo-Villanova, Mario author Soler, Fernando author Jara-Rubio, Rubén author Garrido-Peñalver, Jose Francisco author Pinar, Eduardo author Hernández-Vicente, Álvaro author Hurtado, Jose Antonio author Lax, Antonio author Pascual-Figal, Domingo A author 2022-05 Donation after circulatory death (DCD) represents a promising opportunity to overcome the relative shortage of donors for heart transplantation. However, the necessary period of warm ischemia is a concern. This study aims to determine the critical warm ischemia time based on in vivo biochemical changes. Sixteen DCD non-cardiac donors, without cardiovascular disease, underwent serial endomyocardial biopsies immediately before withdrawal of life-sustaining therapy (WLST), at circulatory arrest (CA) and every 2 min thereafter. Samples were processed into representative pools to assess calcium homeostasis, mitochondrial function and cellular viability. Compared to baseline, no significant deterioration was observed in any studied parameter at the time of CA (median: 9 min; IQR: 7-13 min; range: 4-19 min). Ten min after CA, phosphorylation of cAMP-dependent protein kinase-A on Thr197 and SERCA2 decreased markedly; and parallelly, mitochondrial complex II and IV activities decreased, and caspase 3/7 activity raised significantly. These results did not differ when donors with higher WLST to CA times (≥9 min) were analyzed separately. In human cardiomyocytes, the period from WLST to CA and the first 10 min after CA were not associated with a significant compromise in cellular function or viability. These findings may help to incorporate DCD into heart transplant programs. Am J Transplant. 2022 May;22(5):1321-1328. http://hdl.handle.net/20.500.12105/15633 35114047 10.1111/ajt.16987 1600-6143 American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons Critical warm ischemia time point for cardiac donation after circulatory death.