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Ultrastructure changes associated with brain death in the human donor heart

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Transplant International

Abstract

Electromicroscopic examinations were carried out on 30 myocardial biopsies taken from 22 human donor hearts immediately after excision (prestorage) or immediately before transplantation (post-storage). All electron micrographs were independently examined by two morphologists. Eleven structures were examined in each micrograph, and each structure was scored according to the degree of injury. A good interobserver correlation was obtained in 84 % of the structures scored. In the prestorage left ventricular biopsies (n = 11), approximately 20 %–25 % showed moderate to severe ultrastructural injury. The ultrastructural injury observed in the poststorage left ventricular biopsies (n = 15) was no different from that in the prestorage group, particularly injury to the sarcomere and mitochondria. A similar degree and pattern of injury was seen in the right ventricle (n = 4). There was no evidence that an ischemic storage period of less than 6 h increased the degree of injury seen. However, there was a higher incidence of moderate to severe injury in those hearts excised from donors initially dependent on high inotropic support.

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Novitzky, D., Rhodin, J., Cooper, D.K.C. et al. Ultrastructure changes associated with brain death in the human donor heart. Transplant Int 10, 24–32 (1996). https://doi.org/10.1007/BF02044338

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  • DOI: https://doi.org/10.1007/BF02044338

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