Skip to main content
. 2021 Jun 12;9:89–92. doi: 10.1016/j.xjtc.2021.06.018

Figure 1.

Figure 1

Major steps of the heterotopic transplantation and functional assessment of transplanted hearts. A, The anesthetized donor rat is intubated, ventilated, and the left carotid artery is cannulated to deliver a paralytic agent. B, To induce the donation after circulatory death (DCD) process, the ventilatory support is terminated. Shown as an X mark on the endotracheal tube. C, At the time of procurement, the ascending aorta was clamped distal to the innominate artery, shown as a grey right-angle clamp, and ice-cold University of Wisconsin (UW) solution was delivered through the left carotid artery into the coronary circulation. In a group of DCD hearts, the UW solution was supplemented with the NACHT, LRR, and PYD domains-containing protein-3 (NLRP3) inhibitor (NLRP3-I). Control beating-heart donor (CBD) hearts were procured without ischemia. D, The procured heart was transplanted into the recipient rat's abdomen, which were also pretreated with NLRP3-I or not. A U-shaped vascular clamp, shown as a grey half-circle overlying abdominal aorta and inferior vena cava, was used to isolate a segment of the recipient's abdominal aorta and vena cava. The vascular anastomosis was performed between donor aorta to recipient aorta and donor pulmonary artery to the recipient vena cava. The dotted arrow line between panels C and D represents the donor heart being transplanted into the abdomen of the recipient rat. E, Upon removing the vascular clamp and reestablishment of coronary circulating, the engrafted heart resumed contractions. Following hemostasis, the abdomen was closed in 2 layers of nonabsorbable suture and rats were recovered. After 24 hours, rats were anesthetized and transplanted hearts exposed by opening the abdominal wall. The transplanted heart function was measured with a balloon-tipped catheter introduced in the left ventricle transduced to software, allowing the continuous recording of developed pressure, ± dP/dt. The 3 dotted lines with an arrow represent three study groups of transplanted hearts. F, The graft function measured after 24 hours of transplantation is represented against each group: CBD, DCD, and DCD + NLRP3-I. Developed pressure is measured on the y-axis scaled to 200 mm Hg. The upper third of the panel depicts a normal robust developed pressure from the control group of hearts. The middle third of the panel represents the decreased developed pressure in untreated DCD hearts. The lower third of the panel represents DCD hearts treated with NLRP3-I. They produced a strong developed pressure that matched the control group of hearts.