{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:46:14Z","timestamp":1753879574937,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,3,5]],"date-time":"2017-03-05T00:00:00Z","timestamp":1488672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["TRR127"],"award-info":[{"award-number":["TRR127"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004938","name":"Deutsches Primatenzentrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004938","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Xenotransplantation"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The perioperative phase of preclinical cardiac xenotransplantations significantly affects the experimental outcome. Moderate or even severe hemodynamic and respiratory impairment occurs frequently in baboons after receiving a cardiac transplant. The perioperative management of such postoperative instability is very demanding, especially in the experimental setting. We compared perioperative changes of hemodynamic and laboratory findings during orthotopic and heterotopic thoracic cardiac xenotransplantations and describe our monitoring, treatment and intensive care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010eight pig\u2010to\u2010baboon cardiac xenotransplantations were performed using either the orthotopic (<jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x, n=5) or heterotopic thoracic (ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x; n=23) technique. In both techniques, cardioplegia and an intraoperative cardiopulmonary bypass (<jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content>) were required. Preoperatively, intensive care (eg, transfusions, catecholamine therapy) was provided and fast extubation was targeted. A central venous catheter, a\u00a0femoral arterial thermodilution catheter, a telemetric pressure transmitter and transthoracic echocardiography were used to monitor the animal. Baboon jackets with a tethering system were used to continuously apply medication postoperatively and permit blood sampling, also after extubation of the animal and transfer into the cage. Perioperative survival, hemodynamics, catecholamine doses, respiratory function and weaning from respirator were compared. Perioperative organ damage was evaluated based on laboratory findings 12\u00a0hours after transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recipients could be weaned from <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> in the 20 ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x and all five <jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x experiments, and three ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x procedures were terminated during the operation. The time of cardiopulmonary bypass was significantly lower in the heterotopic group (<jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x median 171 [157\u2010193] minutes; ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x median 144 [100\u2010190] minutes; <jats:italic>P<\/jats:italic>=.02). In 17 ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x procedures, no inotropics were used, whereas epinephrine had to be administered in four of the five <jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x experiments; the mean time of catecholamine support was longer in the <jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x group (<jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x 972\u00b1348\u00a0minutes vs ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x 111\u00b192\u00a0minutes; <jats:italic>P<\/jats:italic>&lt;.01). After ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x, weaning off the respirator was possible in 19 of 20 cases (one died due to pneumothorax). After <jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x, three of the five baboons could be weaned off the respirator; in these cases, the arterial saturation was higher compared with the extubated baboons after ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x (<jats:styled-content style=\"fixed-case\">oHT<\/jats:styled-content>x 99\u00b11% vs ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x 91\u00b14%, <jats:italic>P<\/jats:italic>=.01). Intraoperative blood loss was similar between the two groups, and hemostasis was impaired after all procedures, but relevant postoperative bleeding never occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intensive intra\u2010 and postoperative monitoring and care is required in both transplantation techniques as a requirement for successful weaning from <jats:styled-content style=\"fixed-case\">CPB<\/jats:styled-content> and respirator. After ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x, the animals needed less catecholamines and were hemodynamically more stable. Even though pulmonary function was often impaired after ht<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x, weaning from the respirator and extubation was more successful in this group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/xen.12295","type":"journal-article","created":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T04:32:40Z","timestamp":1488774760000},"source":"Crossref","is-referenced-by-count":14,"title":["Hemodynamic and perioperative management in two different preclinical pig\u2010to\u2010baboon cardiac xenotransplantation models"],"prefix":"10.1111","volume":"24","author":[{"given":"Tanja","family":"Mayr","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Ludwig Maximilian University  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Ludwig Maximilian University  Munich 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