Ultrastructure changes associated with brain death in the human donor heart |
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| Authors: | D Novitzky J Rhodin DKC Cooper Y Ye K-W Min L DeBault |
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| Institution: | Department of Cardiothoracic Surgery, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC, Box16, Tampa, FL 33612-4799, USA Fax:+ 1813 978 5936;Department of Pathology, University of South Florida, Tampa, FL 33612-4799, USA;Oklahoma Transplantation Institute, Baptist Medical Center, 3300 Northwest Expressway, Oklahoma City, OK 73112-4481, USA;Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA |
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| Abstract: | Abstract Electromicroscopic examinations were carried out on 30 myocardial biopsies taken from 22 human donor hearts immediately after excision (prestorage) or immediately before transplantation (post-storage). All electron micrographs were independently examined by two morphologists. Eleven structures were examined in each micrograph, and each structure was scored according to the degree of injury. A good interobserver correlation was obtained in 84 % of the structures scored. In the prestorage left ventricular biopsies ( n = 11), approximately 20 %-25 % showed moderate to severe ultrastructural injury. The ultrastructural injury observed in the poststorage left ventricular biopsies ( n = 15) was no different from that in the prestorage group, particularly injury to the sarcomere and mitochondria. A similar degree and pattern of injury was seen in the right ventricle ( n = 4). There was no evidence that an ischemic storage period of less than 6 h increased the degree of injury seen. However, there was a higher incidence of moderate to severe injury in those hearts excised from donors initially dependent on high inotropic support. |
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| Keywords: | Cardiac donors Ultrastructural changes heart brain death Triiodothyronine |
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