Metabolomic profiling of cardiac allografts after controlled circulatory death

Thaïs Hautbergue; Florent Laverdure; Simon Dang Van; Aurelien Vallee; Mateo Sanchis-Borja; Benoît Decante; Maïra Gaillard; Christophe Junot; François Fenaille; Olaf Mercier; Benoit Colsch; Julien Guihaire

doi:10.1016/j.healun.2023.02.1492

Metabolomic profiling of cardiac allografts after controlled circulatory death

J Heart Lung Transplant. 2023 Jul;42(7):870-879. doi: 10.1016/j.healun.2023.02.1492. Epub 2023 Feb 23.

Affiliations

¹ Département Médicaments et Technologies pour la Santé (DMTS), MetaboHUB, Paris-Saclay University, CEA, INRAE, Gif-sur-Yvette, France.
² Department of Anesthesiology and Intensive Care, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France; Preclinical Research Laboratory, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France.
³ Preclinical Research Laboratory, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France.
⁴ Preclinical Research Laboratory, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France; Department of Cardiac Surgery, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France.
⁵ Preclinical Research Laboratory, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France; Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France; INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Paris-Saclay University, Hôpital Marie Lannelongue, Le Plessis-Robinson, France; Paris-Saclay University School of Medicine, Le Kremlin-Bicêtre, France.
⁶ Preclinical Research Laboratory, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France; Department of Cardiac Surgery, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France; Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Paris-Saclay University, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Pulmonary Hypertension National Referral Center, Le Plessis Robinson, France. Electronic address: julienguihaire@gmail.com.

PMID: 36931989
DOI: 10.1016/j.healun.2023.02.1492

Abstract

Background: Assessment of myocardial viability during ex situ heart perfusion (ESHP) is based on the measurement of lactate concentrations. As this provides with limited information, we sought to investigate the metabolic signature associated with donation after circulatory death (DCD) and the impact of ESHP on the myocardial metabolome.

Methods: Porcine hearts were retrieved either after warm ischemia (DCD group, N = 6); after brain-stem death (BSD group, N = 6); or without DCD nor BSD (Control group, N = 6). Hearts were perfused using normothermic oxygenated blood for 240 minutes. Plasma and myocardial samples were collected respectively every 30 and 60 minutes, and analyzed by an untargeted metabolomic approach using liquid chromatography coupled to high-resolution mass spectrometry.

Results: Median duration of warm ischemia was 23 minutes [19-29] in DCD animals. Lactate level within myocardial biopsies was not significantly different between groups at T0 (p = 0.281), and remained stable over the 4-hour period of ESHP. More than 300 metabolites were detected in plasma and heart biopsy samples. Compared to BSD animals, metabolomics changes involving energy and nucleotide metabolisms were observed in plasma samples of DCD animals before initiation of ESHP, whereas 2 metabolites (inosine monophosphate and methylbutyrate) exhibited concentration changes in biopsy samples. Normalization of DCD metabolic profile was remarkable after 4 hours of ESHP.

Conclusion: A specific metabolic profile was observed in DCD hearts, mainly characterized by an increased nucleotide catabolism. DCD and BSD metabolomes proved normalized during ESHP. Complementary investigations are needed to correlate these findings to cardiac performances.

Keywords: donation after circulatory-determined death; ex situ heart perfusion; heart transplantation; metabolomics.

MeSH terms

Allografts
Animals
Death
Heart Transplantation* / methods
Lactates
Metabolomics
Nucleotides
Organ Preservation / methods
Perfusion / methods
Swine
Tissue Donors

Substances

Lactates
Nucleotides