This study was designed to determine whether the novel
perfluoroperhydrophenanthrene-egg yolk
phospholipid emulsion,
APE-LM, was an effective
oxygen carrier for long-term hypothermic heart preservation. We postulated that hearts preserved with
APE-LM would be well oxygenated during 24-hour preservation and that reperfusion of such hearts with blood would not produce functional or metabolic evidence of
myocardial ischemia. Four groups of rabbit hearts were studied (n = 7 per group): fresh controls: nonpreserved, nontransplanted hearts; surgical controls: fresh hearts transplanted heterotopically for 75 minutes before explant and study for 4 hours as isolated working hearts perfused at 37 degrees C;
crystalloid-preserved: hearts preserved with
crystalloid medium, followed by
transplantation and isolated heart perfusion;
APE-LM-preserved: hearts treated as those in the
crystalloid-preserved group, but preservation was with medium containing
APE-LM emulsion (10 ml/dl). Preservation was with continuous coronary perfusion at 18 mm Hg pressure, 12 degrees C, and
oxygen tension 838 +/- 11 mm Hg. During preservation,
APE-LM hearts had significantly higher
pyruvate consumption, and correspondingly higher oxygen consumption, than that of
crystalloid hearts. No significant differences were found among fresh controls, surgical controls, and
APE-LM-preserved hearts with respect to contractile or output function, oxygen consumption and efficiency indexes, or
lactate production during in vitro perfusion. Left ventricular peak systolic pressure and peak rate of pressure development were significantly lower for
crystalloid-preserved hearts than for fresh and surgical controls. Left ventricular end-diastolic pressure of
crystalloid-preserved hearts was higher than that of the other three groups. The data indicate that rabbit hearts in this model were well preserved with
APE-LM and that this
emulsion produced better recovery of function than did
crystalloid preservation, possibly as a consequence of the high
oxygen delivery by the
fluorocarbon during preservation.