The effect of short-term coronary perfusion using a perfusion apparatus on canine heart transplantation from non-heart-beating donors.

Abstract

BACKGROUND:

We investigated the effects of briefly perfusing hearts from non-heart-beating donors (NHBDs) with a Celsior solution before cardiac transplantation.

METHODS:

Donor hearts were left in situ for 20 minutes after cardiac arrest was induced by rapid exsanguination. Twelve donor-recipient pairs of mongrel dogs were divided into 2 groups, the simple immersion (SI, n = 6) group and the coronary perfusion (CP, n = 6) group. Both groups underwent coronary flushing with Celsior, after which hearts from the SI group were stored using simple immersion for 4 hours and hearts from the CP group underwent 1 hour of further perfusion followed by storage for 3 hours. Orthotopic transplantation was then performed. We measured cardiac output, end-systolic maximal elastance (E(max)), left ventricular pressure, and rate pressure product 1 and 2 hours after weaning from cardiopulmonary bypass (CPB). Two hours after weaning from CPB, the hearts were harvested for histopathologic study and to determine the percentage of water content.

RESULTS:

The cardiac output (CO) recovery rate was significantly higher in the CP group than in the SI Group 1 hour after weaning from CPB (p < 0.05). The CO recovery rate, E(max), and rate pressure product were significantly higher and the percentage of water content was significantly lower in the CP group than in the SI Group 2 hours after weaning from CPB (p < 0.05). Histopathologic damage was more severe in the SI group.

CONCLUSIONS:

The results of this study suggest that short-term coronary perfusion with a Celsior solution may be useful for heart transplantation from NHBDs.

• Authors: Norimasa Koike, Izumi Takeyoshi, Shigeru Ohki, Hirofumi Tsutsumi, Koshi Matsumoto, Yasuo Morishita
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 22 Issue 7 Pg. 810-7 (Jul 2003) ISSN: 1053-2498 [Print] United States
• PMID: 12873550 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Topics

• Animals
• Cardiac Output (physiology)
• Cardiopulmonary Bypass
• Disease Models, Animal
• Dogs
• Electric Countershock
• Eosinophils (metabolism)
• Heart Arrest, Induced (adverse effects)
• Heart Transplantation
• Mitochondria, Heart (metabolism, pathology)
• Models, Cardiovascular
• Myocardial Contraction (physiology)
• Myocardial Reperfusion
• Myocytes, Cardiac (metabolism, pathology)
• Organ Preservation
• Severity of Illness Index
• Time Factors
• Treatment Outcome
• Ventricular Fibrillation (etiology, physiopathology, therapy)
• Ventricular Pressure (physiology)
• Water-Electrolyte Balance (physiology)