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Fig. 1 | Intensive Care Medicine Experimental

Fig. 1

From: A clinically relevant sheep model of orthotopic heart transplantation 24 h after donor brainstem death

Fig. 1

Experimental timeline for donor BSD and subsequent HTx. All sheep were approved for use by the facility veterinarian after a comprehensive health check. Prior to allocation, experimental sheep were matched for weight and blood compatibility [17], then paired and randomly assigned to either donor sham (control without neurological injury) or BSD groups (n = 4/group). Sheep within each pair were then randomly allocated as an experimental donor or recipient. Following standard instrumentation procedures, donor animals were rested for 1 h prior to induction of BSD/sham (ST). Following confirmation of BSD (T0 in the donor), donors were administered hormone resuscitation 2 h thereafter (T2), and monitored for 24 h in intensive care settings, prior to donor heart procurement and heart preservation by cold static storage (CSS). In donors, at baseline (B), stabilisation (ST), upon confirmation of BSD/sham (T0), and 1, 3, 6, 9, 12, 18 and 24 h thereafter, arterial blood was collected for determination of full blood counts, plasma catecholamines, inflammatory markers and cardiac troponin I. Periodic epicardial echocardiography was performed to measure cardiac function at all aforementioned timepoints in donor (except baseline). The recipient was prepared and underwent instrumentation procedures prior to establishment of CPB. The donor heart was implanted into the recipient, and the cardiac allograft was reperfused (Rep.) for 30 min prior to any attempt to wean from CPB (ACC: aortic cross-clamp). After successful weaning from CPB (T0 in recipient), the recipient was followed up for 6 h and then euthanized. In recipients, arterial blood was collected at baseline, stabilisation, and 0.5, 1, 2, 3, 4 and 6 h after weaning from CPB (T0) for determination of full blood counts, plasma catecholamines, inflammatory markers and cardiac troponin I. In recipient animals, echocardiography was performed at stabilisation, T0 and 1, 3 and 6 h thereafter

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