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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.zaDOI: 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.comDepartment 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