Noninvasive assessment of heterotopic heart transplants using Doppler echocardiography was first described in two patients by Allen at Stanford in 1981. Since then, numerous experiments studying heterotopic heart transplantation in humans and large animals have confirmed its utility by employing either an intra-abdominal or cervical model. In rats, however, prior research investigating intra-abdominal heterotopic hearts has showed echocardiography to be ineffective. We have recently developed a new technique for heterotopic femoral heart transplantation in rats, which employs the novel use of trans-femoral echocardiography. Therefore, our goal was to re-examine the efficacy of echocardiography for detection of graft rejection.
[Show abstract][Hide abstract] ABSTRACT: Heterotopic heart transplantation in rats and mice is the most commonly used model to study allograft immune response and to test immunosuppressive drugs and tolerance induction protocols. Standardization of both the surgical procedure and the evaluation of graft function is essential for data interpretation. The most popular way to monitor graft function has been the palpation method. However, there are some proposal for more objective assessment methods like electrocardiogram and echocardiogram. Although, complementary tests might add some relevant information when assessing minor effects of immunosuppressive therapy, palpation by an experienced investigator is very predictive and so far the simplest method to determine heart allograft function. Minor complications during the surgical procedure and unreliable assessment can have a major impact on the interpretation of experiment results. Here, the author reviews the literature and presents some suggestions that help eliminating biases on the assessment of heart allograft function.
[Show abstract][Hide abstract] ABSTRACT: Left ventricular-assist device (LVAD) can lead to improvement of cardiac performance in a subset of patients, but chronic mechanical unloading in this fashion may result in left ventricular (LV)-atrophy and impaired functional recovery. Here, we evaluate the efficacy of transferring bone-marrow KSL cells (Lin-/c-kit+/Sca1+), a fraction containing endothelial progenitor cells, for preventing LV-atrophy and malfunction in a mouse model of mechanical unloading of the heart.
Recipients of an isogenic heart transplant received intramyocardial isogenic KSL cells or PBS in three different locations of the left ventricle (LV). Coronary blood flow and LV systolic function were evaluated by echocardiography, and morphologic changes were analyzed on d 7 and 56.
PBS-treated mice showed severe systolic dysfunction and large thrombi in LV at both time points. In contrast, KSL cell transfer markedly reduced systolic dysfunction and thrombus size. Furthermore, in comparison with PBS control, KSL recipients had increased coronary blood flow (3-fold, P < 0.01) accompanied by increased LV capillary density and muscle mass.
These results indicate that intramyocardial transfer of bone marrow KSL cells significantly protects against coronary insufficiency and systolic dysfunction in the chronic LV-unloading heart, suggesting that this approach may have clinical potential as a combination therapy with LVAD.
Journal of Surgical Research 02/2010; 171(1):47-57. DOI:10.1016/j.jss.2010.01.042 · 1.94 Impact Factor
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