Graft Preservation with heparinized blood/saline solution induces server graft dysfunction
Graft Preservation with heparinized blood/saline solution induces server graft dysfunction
As we have learned in class, coronary artery bypass grafting (CABG) is the most common surgical procedure performed on the heart and the patient’s prognosis largely depends on the long-term patency of the bypass grafts. In practice, grafts are stored at temperatures between 4 C and room temperature in various preservation solutions including saline, heparinized blood, or Custodial solution (Veres et al., 2014). According to Veres et al. (2014), heparinized autologous blood solutions is considered the most suitable solution for storing human arterial and venous grafts and samples, however there have been conflicting results on the effect of this solution on endothelial cells. This article looked at the early and mid-term effect of ischemia/reperfusion injury on endothelial cells of implanted grafts using a rat model of aortic transplantation. They examined the both the functional and molecular aspects of endothelial dysfunction induced.
A major finding of this study was that application of the daily used physiological saline or heparinized blood to preserve the arterial graft was incapable of reducing the endothelial damage after cold storage and warm reperfusion (Veres et al, 2014). They also concluded that both had similar weak preservation effect on the endothelial cells, however blood preservation solutions had a negative impact on these cells as compared to normal saline solution.
The peak of endothelial damage in both heparinized and saline groups occurred after twenty-four hours of reperfusion. This is said to correlate with the early complications in bypass grafts that lead to transient ST segment elevations occurring in the first 12-24 hours after CABG (Veres et al., 2014). Additionally this study found that endothelial integrity was damaged however it took the cells sample about one week of reperfusion to recover supporting previous findings of the ability of endothelial cells to regain functional integrity.
This study is important because the goal and current protocol for graft recovery is to minimize mechanical damaged during harvesting and this study demonstrates that both saline and heparinized blood solutions are incapable of this function as previously believed.
Veres, G., Hegedus, P., Barnucz, E., Zoller, R., Klien, S., Radovits, T., Korkmax, S., Karck, M. & Szabo, G. (2014). Graft Preservation with heparinized blood/saline solution induces server graft dysfunction. Interactive CardioVasular and Thorasic Surgery. 1-7. doi:10.1093/icvts/ivv010.
Camarillo, Calif., Feb. 10, 2015— Research she conducted as an undergraduate has earned CSU Channel Islands (CI) graduate student Dana Cochran a coveted spot in the 2015 “Posters on the Hill” event in Washington D.C.
Michael Jordan has been quoted to say “I can accept failure, everyone fails at something. But I can’t accept not trying.” The role of failure in research is just that: not trying, or more specifically, giving up when it becomes “too” challenging. If everyone gave up prior to being “successful,” we would not have the endless list of great inventions and innovations, evidence-based practice in medicine, the phenomenal insight gained by various research projects and methods, as well as the many technological advancements that make our lives a lot easier. Thomas Edison, the American inventor and businessman stated, “I have not failed. I’ve just found 10,000 ways that won’t work.” One of the main purposes of research is to discover what works in respective fields, and what does not. This is the ultimate question: just because something takes many more attempts that one originally thought, should that constitute as failure? And if so, what is the magic number of “failures” that someone should then give up? More importantly, what is the definition of failure?
In my undergraduate research experience at CSU Channel Islands just like every day life, there are always “dead-ends” hit and obstacles to overcome; what matters is what you do during these trying times. As Bill Gates said, “It’s fine to celebrate success but it is more important to heed the lessons of failure.” Failing at something teaches you what to do different the next time. Period. It does not mean to give up, throw in the hat, and quit. Alternatively, if one loses the passion and drive they had at the start of the endeavor, moving forward with something else may be what is needed. There is so much variation to account for when conducting research, which is why there is no right answer to the question: at what point should one “admit failure” and move on to something else in research? Each person needs to realize there will be obstacles no matter what field or how much experience they have. Furthermore, each person needs to define what both failure and success means to them. Success to me is not defined in the same way, nor does it feel the same as the person next to me.
Although I am not aware of how Wakefield et al. (1998) personally dealt with the failure, I am aware of all the successful research that has been conducted since then to dispel and disprove anything remotely close to the claims of Wakefield et al. (1998). Donald Trump said it best: “Sometimes by losing a battle you find a new way to win the war.” Although no data supporting an association between MMR vaccine and autism existed and a plausible biological mechanism was lacking, several epidemiologic studies were performed to address parental fears created by the publication by Wakefield et al. (1998). Fortunately, several features of large-scale vaccination programs allowed for excellent descriptive and observational studies—specifically, large numbers of subjects, which generated substantial statistical power; high-quality vaccination records, which provided reliable historical data; multinational use of similar vaccine constituents and schedules; electronic medical records, which facilitated accurate analysis of outcome data; and the relatively recent introduction of MMR vaccine in some countries, which allowed for before and after comparisons (Infectious Diseases Society of America, 2015). This particular failure of Wakefield et al. (1998) led to enormous success of looking further into the association of autism and vaccines as well as research on vaccines and their benefits/purpose in general. The famous psychologist B.F. Skinner once said, “A failure is not always a mistake, it may simply be the best one can do under the circumstances. The real mistake is to stop trying.”