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Eur J Cardiothorac Surg 2001;19:321-325
© 2001 Elsevier Science NL

Investigations on the new free radical scavenger polynitroxyl-albumin to prevent ischemia and reperfusion injury after orthotopic heart transplantation in the pig model

^a Department of Cardiovascular Surgery, Albert-Ludwigs-University, Hugstetter Strasse 55, D-79106 Freiburg, Germany
^b Department of Surgical Research, Albert-Ludwigs-University, Freiburg, Germany
^c Department of Cardiovascular Surgery, Sapporo University Medical Center, Sapporo, Japan
^d Faculdade de Medicina de Marilia e Faculdade de Medicina de Botucatu, State University of São Paulo, São Paulo, Brazil

Received 2 August 2000; received in revised form 22 November 2000; accepted 13 December 2000.

Corresponding author. Tel.: +49-761-270-2818; fax: +49-761-270-2550
e-mail: martin{at}ch11.ukl.uni-freiburg.de

Objective: Nitroxides have strong antioxidant capacity but their effectiveness is limited by their rapid intracellular inactivation. Polynitroxyl-Albumin (PNA) is capable of regenerating inactivated nitroxide. We tested the effect of PNA against reperfusion injury in heart transplantation. Methods: Pig hearts were transplanted orthotopically. In the control group (n=9) reperfusion was performed without reperfusion modifications. In the experimental group (n=10) 1 ml/kg PNA was given before cross-clamp release. Results: Hemodynamic performance was impaired after transplantation in both groups without significant intergroup differences. Plasma malonedialdehyde levels were significantly diminished in the PNA group as compared to the controls. CK-MB levels in both groups were increased within the first 2 h of reperfusion without significant intergroup differences. In contrast, there were found significant higher values of myocardial specific lactate dehydrogenase (LD1) in the controls versus PNA group. Conclusions: PNA was able to reduce lipid peroxidation and attenuate free radical activity. Contractile dysfunction could no be improved, indicating that (a) the radical scavenging effect was to weak or (b) other mechanisms than free oxygen radicals are responsible for myocardial damage in this experimental model.

Key Words: Reperfusion injury • Heart transplantation • Free radical scavenger • Polynitroxyl-albumin

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