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Tiprotec preserves endothelial function after cold ischemia and warm reperfusion: comparison between Saline, Custodiol and Tiprotec


Background: Coronary artery bypass surgery provides excellent patency rates, however the early/late graft failure reduces the long-term benefit of myocardial revascularization.


We investigated the effectiveness of generally used Saline, Custodiol solutions and a new solution (Tiprotec) at preserving endothelium after cold ischemia and warm reperfusion injury.


Aortic transplantations were performed in Lewis rats. Aortic arches stored in Saline, Custodiol and Tiprotec solutions for 2 hours, then were transplanted into abdominal aorta. Two, 24 hours and 1 week after transplantation, the implanted grafts were harvested. Endothelium-dependent and-independent vasorelaxations were investigated in organ bath. DNA strand breaks were assessed by TUNEL-method, mRNA expressions by quantitative real-time PCR and the expression of CD-31 and α-SMA by immunochemistry.


Severely impaired endothelial function and integrity of implanted aortic grafts were shown after 2h in the Saline, Custodiol group (maximal vasorelaxation to acetylcholine: control:91 ± 2%, Saline:26 ± 5%, Custodiol:24 ± 5%, CD31 positive area control:96 ± 2%, Saline:35 ± 13% Custodiol:54 ± 5%, p < 0.05, respectively), however a preserved endothelial function was observed in the Tiprotec group when compared to the Saline and Custodiol group (maximal vasorelaxation:46 ± 7%, CD31 positive area:54 ± 10%, p < 0.05). After 1 week, endothelial function were partially recovered in all groups, however it was significantly better in the Tiprotec group (maximal vasorelaxation to acetylcholine: Saline:42 ± 3%, Custodiol:48 ± 3%, Tiprotec:56 ± 3%, CD31 positive area: Saline:56 ± 5%, Custodiol:54 ± 4%; Tiprotec:83 ± 6%, p < 0.05, respectively). In addition, mRNA levels of Bax, Bcl-2, eNOS, VEGF-2 and caspase-3 were significantly altered in both groups.


Tiprotec appears to be superior for the preservation of endothelial- and smooth muscle cells of bypass graft after cold storage and warm reperfusion in our murine model.

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Gábor, V., Péter, H., Schmidt, H. et al. Tiprotec preserves endothelial function after cold ischemia and warm reperfusion: comparison between Saline, Custodiol and Tiprotec. J Cardiothorac Surg 10 (Suppl 1), A74 (2015).

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