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Enhancement of Mesenchymal Stem Cell Expansion by Activated Autologous Serum - Implications for Clinical Grade Expansion
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Enhancement of Mesenchymal Stem Cell Expansion by Activated Autologous Serum - Implications for Clinical Grade Expansion

Principal Investigator

PD Dr. Yeong-Hoon Choi, Prof. Dr. Throsten Wahlers

 

Projektleiter

Dr. Klaus Neef

 

Doktorandin

Angelika Weichel

 

Objectives
Previously we showed that circulating endothelial cells (CEC) are a sensitive marker for endothelial injury in patients undergoing CABG applying different cardiopulmonary-bypass-setups (CPB). We also showed that Calafiore (CAL) cardioplegia has poor cardioprotective properties in patients undergoing cardiac surgical procedures with prolonged aortic cross-clamp times (>80 min.) compared to Buckberg (BUCK) cardioplegia. In this study we investigated the cardioprotective characteristics of CAL versus BUCK determined by CEC.

Methods
CECs were quantified by magnetic-bead-isolation from 68 patients who underwent elective CABG. Patients were divided into groups based on the cardioplegia. Samples were obtained preoperatively, 1h and 24h postoperatively. Plasma/serum levels of vonWillebrand factor (vWF), soluble thrombomodulin (sTm), creatin-kinase (CK/CK-MB) and troponinT were measured parallelly.

Results
There was no significant difference in terms of demographic data, preoperative risk-profile, CPB-time, no. of bypasses and aortic cross-clamp-time (37±12 min. vs. 41±18 min., p=0.481). The postoperative course was smooth in both groups with no adverse events. CK/CK-MB and troponinT were increased in CAL at 24h but did not reach significance (967±221/6±3.8% U/l vs. 735±261/4.2±3.2% U/l, p=0.321). However, CECs were significantly elevated in CAL vs. BUCK at 1h with normalization at 24h postoperatively (18.4±4.1 vs. 10.1±3.9, p=0.012). Likewise, the endothelial plasma markers were elevated at 1 h (vWF: 258.2±89.7 U/dl vs. 178.4±73.2 U/dl, p=0.001; sTm: 5.2±2.4 ng/ml vs. 3.2±2.1 ng/ml, p=0.011) but remained elevated during the observation period.

Conclusions
The number of circulating endothelial cells reveals the poor cardioprotective characteristics of Calafiore cardioplegia, which is masked in patients with brief aortic cross-clamptime and may not reach clinical relevance.