Preservation of endothelial vascular function of saphenous vein grafts after long-time storage with a recently developed potassium-chloride and N-acetylhistidine enriched storage solution

TY - JOUR

T1 - Preservation of endothelial vascular function of saphenous vein grafts after long-time storage with a recently developed potassium-chloride and N-acetylhistidine enriched storage solution

AU - Wilbring, Manuel

AU - Tugtekin, Sems Malte

AU - Zatschler, Birgit

AU - Ebner, Annette

AU - Reichenspurner, Hermann

AU - Kappert, Utz

AU - Matschke, Klaus

AU - Deussen, Andreas

N1 - Georg Thieme Verlag KG Stuttgart · New York.

PY - 2013/12

Y1 - 2013/12

N2 - OBJECTIVES: Saphenous vein grafts are still commonly used in cardiac, vessel and also in transplant surgery. In cardiac surgery, a desperate graft situation could force to keep nonutilized explanted vein segments after CABG in reserve for case of early graft failure. Historically there were no options for adequate long-time graft storage protecting the endothelial layer with its important antithrombotic and immunosuppressive functional aspects. Commonly isotonic saline solution (sodium chloride [NaCl]) has been used as a storing solution in this case. We investigated the impact of long-time storage in NaCl and a recently developed potassium-chloride and N-acetylhistidine enriched storage solution (TiProtec, Dr. Köhler Chemie, Germany) on endothelial function of saphenous veins.METHODS: Saphenous vein segments (n = 19) were intraoperatively isolated and stored for 24 and 96 hours. The segments were examined in a Mulvany-myograph to assess vessel function. Following preconstriction with norepinephrine, dose-response curves were assessed for relaxation with bradykinin and sodium-nitroprusside. We compared developed maximum wall tension and endothelial cell and smooth muscle cell (SMC) dependent vasodilatory function.RESULTS: Maximum vessel wall tension was significantly better preserved in TiProtec-stored vessels after 24 h in comparison to segments stored in NaCl (5.11 ± 4.79 mN/mm vs. 2.48 ± 2.43 mN/mm; p = 0.033) and 96 h (4.94 ± 2.82 mN/mm vs. 2.80 ± 1.76 mN/mm; p = 0.042). Likewise endothelium-derived vasodilatory function was maintained significantly after 24 hours in TiProtec-stored vessels (36.9 ± 2.6% vs. 11.8 ± 30.9%; p = 0.005). After 96 hours, endothelium-dependent vascular function was nearly abolished in NaCl-stored vessels, but largely preserved in TiProtec-stored segments (20.6 ± 2.9% vs. 1.9 ± 4.3% in NaCl; p = 0.015). Sodium nitroprusside-mediated SMC-vasodilatory function was better maintained after 24 hours of storage in TiProtec group (88.8 ± 6.4% vs. 61.3 ± 8.2%; p = 0.009). After 96 hours of storage, SMC relaxation did not significantly differ between both storage groups which might be due to a distinct reduction of contractile function in NaCl-stored vessels (98.6 ± 5.0% and 77.9 ± 10.5% for Tiprotec and NaCl, respectively).CONCLUSION: Vessel functions comprising contraction, endothelium-dependent and -independent vasodilatation are significantly reduced following 24 hours of cold storage in NaCl. After 96 hours of storage in NaCl these functions are nearly totally abolished. TiProtec is able to largely reduce this loss of function during cold storage. Therefore, TiProtec is a feasible option for longer term storage of saphenous vein grafts in CABG vessel and transplant surgery.

AB - OBJECTIVES: Saphenous vein grafts are still commonly used in cardiac, vessel and also in transplant surgery. In cardiac surgery, a desperate graft situation could force to keep nonutilized explanted vein segments after CABG in reserve for case of early graft failure. Historically there were no options for adequate long-time graft storage protecting the endothelial layer with its important antithrombotic and immunosuppressive functional aspects. Commonly isotonic saline solution (sodium chloride [NaCl]) has been used as a storing solution in this case. We investigated the impact of long-time storage in NaCl and a recently developed potassium-chloride and N-acetylhistidine enriched storage solution (TiProtec, Dr. Köhler Chemie, Germany) on endothelial function of saphenous veins.METHODS: Saphenous vein segments (n = 19) were intraoperatively isolated and stored for 24 and 96 hours. The segments were examined in a Mulvany-myograph to assess vessel function. Following preconstriction with norepinephrine, dose-response curves were assessed for relaxation with bradykinin and sodium-nitroprusside. We compared developed maximum wall tension and endothelial cell and smooth muscle cell (SMC) dependent vasodilatory function.RESULTS: Maximum vessel wall tension was significantly better preserved in TiProtec-stored vessels after 24 h in comparison to segments stored in NaCl (5.11 ± 4.79 mN/mm vs. 2.48 ± 2.43 mN/mm; p = 0.033) and 96 h (4.94 ± 2.82 mN/mm vs. 2.80 ± 1.76 mN/mm; p = 0.042). Likewise endothelium-derived vasodilatory function was maintained significantly after 24 hours in TiProtec-stored vessels (36.9 ± 2.6% vs. 11.8 ± 30.9%; p = 0.005). After 96 hours, endothelium-dependent vascular function was nearly abolished in NaCl-stored vessels, but largely preserved in TiProtec-stored segments (20.6 ± 2.9% vs. 1.9 ± 4.3% in NaCl; p = 0.015). Sodium nitroprusside-mediated SMC-vasodilatory function was better maintained after 24 hours of storage in TiProtec group (88.8 ± 6.4% vs. 61.3 ± 8.2%; p = 0.009). After 96 hours of storage, SMC relaxation did not significantly differ between both storage groups which might be due to a distinct reduction of contractile function in NaCl-stored vessels (98.6 ± 5.0% and 77.9 ± 10.5% for Tiprotec and NaCl, respectively).CONCLUSION: Vessel functions comprising contraction, endothelium-dependent and -independent vasodilatation are significantly reduced following 24 hours of cold storage in NaCl. After 96 hours of storage in NaCl these functions are nearly totally abolished. TiProtec is able to largely reduce this loss of function during cold storage. Therefore, TiProtec is a feasible option for longer term storage of saphenous vein grafts in CABG vessel and transplant surgery.

KW - Aged

KW - Cold Temperature

KW - Dose-Response Relationship, Drug

KW - Endothelium, Vascular/drug effects

KW - Female

KW - Histidine/analogs & derivatives

KW - Humans

KW - Isotonic Solutions

KW - Male

KW - Middle Aged

KW - Organ Preservation/methods

KW - Organ Preservation Solutions/pharmacology

KW - Potassium Chloride/pharmacology

KW - Saphenous Vein/drug effects

KW - Sodium Chloride/pharmacology

KW - Time Factors

KW - Tissue and Organ Harvesting

KW - Vasoconstriction/drug effects

KW - Vasoconstrictor Agents/pharmacology

KW - Vasodilation/drug effects

KW - Vasodilator Agents/pharmacology

U2 - 10.1055/s-0032-1311549

DO - 10.1055/s-0032-1311549

M3 - SCORING: Journal article

C2 - 22791204

VL - 61

SP - 656

EP - 662

JO - THORAC CARDIOV SURG

JF - THORAC CARDIOV SURG

SN - 0171-6425

IS - 8

ER -