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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 3, May/June 2015

104

AFRICA

Cardiovascular Topics

Comparison of MMF with prednisone in terms of rejection

and duration of activity of transplant in rabbits that

underwent retroperitoneal heterotopic heart transplantation

Fatih Aygün, Duran Efe, Kadir Durgut

Abstract

Aim:

In this study, mycophenolate mofetil (MMF) and meth-

ylprednisolone (MP) were compared in terms of rejection and

duration of activity of the transplant in New Zealand rabbits

that underwent retroperitoneal heart transplantation.

Methods:

Retroperitoneal heart transplantation was

performed in New Zealand white rabbits. The animals were

divided into two groups. MMF group (group 1) (10 donors,

10 recipients): 12.5 mg/kg MMF was administered orally

for two days prior to the surgery; MP group (group 2) (nine

donors, nine recipients): 2 mg/kg MP was administered intra-

muscularly for two days prior to the surgery. After the opera-

tion, we waited until all motor activity in the transplanted

heart had stopped. The transplant was then removed and

the recipient was sacrificed. A donor in the MP group was

excluded since it died before the motor activity had stopped.

Results:

No statistically significant difference was found

between the groups in terms of rejection score (

p

=

0.865).

However, duration of motor activity was found to be statisti-

cally significantly longer in the MMF group, compared to the

MP group (

p

=

0.013).

Conclusion:

In this experimental study, MMF was similar to

MP in terms of rejection but had better efficacy in terms of

duration of motor activity of the transplant.

Keywords:

heart transplantation, mycophenolate mofetil, methyl-

prednisolone

Submitted 21/3/14, accepted 28/5/14

Cardiovasc J Afr

2015;

26

: 104–108

www.cvja.co.za

DOI: 10.5830/CVJA-2014-032

Besides the bicaval anastomosis technique developed in recent

years, orthotopic heart transplantation has been successfully

performed in the treatment of thousands of patients with heart

failure using the surgical technique defined in 1960 by Lower and

Shumway.

1

Heart transplantation has become more common

along with advances in preserving organs, illumination of the

immunological basis of transplantation, and the constitution

of organ transplantation centres to obtain and share organs.

The results of experienced centres are similar because heart

transplantation has not developed substantially since the 1990s.

2

Basic problems in the last decade include long waiting lists

and extended waiting periods, increased numbers of emergent

and pre-emptor patients, and prolonged duration of donor

ischaemia. Today, although one-year life expectancy has been

reported to be higher than 85%, and 10-year life expectancy

50–60% in the majority of heart surgery centres, it is estimated

that the parametric curve will rise to 75% in the next decade

along with advances made in recent years.

3-5

Survival after heart transplantation has been extended and

substantial progress has been made in heart transplantation

practices along with the discovery of immunosuppressive agents.

However, the side effects of these immunosuppressive agents and

the presence of coronary lesions in the transplanted graft due to

extended survival times have become a problem. Reduction in

the number of side effects and prevention of the development

of vascular lesions in transplanted hearts have been the target of

new-generation immunosuppressive agents.

Mycophenolate mofetil (MMF) is under investigation in

terms of its effect on vascular lesions and survival in transplanted

hearts, as well as non-cardiac transplantation and paediatric

cardiac surgery.

1,6

In the present study, the effect of MMF versus

methylprednisolone (MP) on acute rejection and duration of

motor activity in the transplant was investigated in a rabbit

model of retroperitoneal heterotopic heart transplantation.

Methods

In this study, 38 New Zealand rabbits weighing between 2 550

and 3 200 g were used. The study was conducted in accordance

with the ethical committee directive for experimental animals

of the Faculty of Medicine, Selçuk University, Meram and the

Experimental Medicine Research and Practice Centre, which

was prepared based on the Universal Declaration on Animal

Welfare, European Convention for the Protection of Vertebrate

Animals Used for Experimental or Other Scientific Purposes,

Department of Cardiovascular Surgery, Faculty of

Medicine, Mevlana University, Konya, Turkey

Fatih Aygün, MD,

fatihaygun@ttmail.com

Department of Radiology, Faculty of Medicine, Mevlana

University, Konya, Turkey

Duran Efe, MD

Department of Cardiovascular Surgery, Faculty of

Medicine, Erbakan University, Konya, Turkey

Kadir Durgut, MD