Effects of Custodiol-N, a novel organ preservation solution, on ischemia/reperfusion injury  Sivakkanan Loganathan, Tamás Radovits, MD, PhD, Kristóf Hirschberg,

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Effects of Custodiol-N, a novel organ preservation solution, on ischemia/reperfusion injury  Sivakkanan Loganathan, Tamás Radovits, MD, PhD, Kristóf Hirschberg, MD, PhD, Sevil Korkmaz, PhD, Achim Koch, MD, Matthias Karck, MD, Gábor Szabó, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 139, Issue 4, Pages 1048-1056 (April 2010) DOI: 10.1016/j.jtcvs.2009.09.034 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Hemodynamic analysis. A, Left ventricular peak systolic pressure – left ventricular volume. B, Maximum pressure development (dP/dtmax) – left ventricular volume. C, Left ventricular end-diastolic pressure – left ventricular volume. D, Minimum pressure development (dP/dtmin) at an intraventricular volume of 80 μL after 1 hour of reperfusion. All values are given as mean ± standard error of the mean (SEM). ∗P < .05 vs other groups. LVSP, Left ventricular peak systolic pressure; LVV, left ventricular volume; LVEDP, left ventricular end-diastolic pressure. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1048-1056DOI: (10.1016/j.jtcvs.2009.09.034) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Coronary blood flow. Baseline coronary blood flow (A) and vasodilator response after application of the endothelium-dependent vasodilator bradykinin (0.1 nmol, 0.2 mL, B) and the endothelium-independent vasodilator SNP (10 nmol, 0.2 mL, C). All values are given as mean ± SEM. ∗P < .05 vs corresponding control. CBF, Coronary blood flow; BRK, bradykinin; SNP, sodium nitroprusside. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1048-1056DOI: (10.1016/j.jtcvs.2009.09.034) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Vascular function after 24-hour cold storage. Concentration-response curves of acetylcholine. A, Acetylcholine-induced endothelium-dependent vasorelaxation in aortic rings after 24-hour cold ischemic storage. B, SNP-induced endothelium-independent vasorelaxation in aortic rings after 24-hour cold ischemic storage. C, Acetylcholine-induced endothelium-dependent vasorelaxation in aortic rings after 24-hour cold ischemic storage and additional NaOCl preincubation. D, SNP-induced endothelium-independent vasorelaxation in aortic rings after 24-hour cold ischemic storage and additional NaOCl preincubation. Each point on the curves and each column represent the mean ± SEM of 16 experiments in thoracic aortic rings of the different groups. ∗P < .05 vs absolute control. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1048-1056DOI: (10.1016/j.jtcvs.2009.09.034) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Histologic analysis. TUNEL staining after 1 hour and 24 hours of reperfusion; Control group also shows high apoptosis rate (grey-brown–colored nuclei) after 1 hour (A) and 24 hours (C). Custodiol-N group rarely shows any apoptotic cells after 1 hour (B) and 24 hours (D); apoptosis index (E). Control after 1-hour reperfusion versus Custodiol-N after 1-hour reperfusion and control after 24-hour reperfusion versus Custodiol-N after 24-hour reperfusion. Values are given as mean ± SEM. ∗P < .05 vs corresponding control; 200× magnification. CN, Control. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1048-1056DOI: (10.1016/j.jtcvs.2009.09.034) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions