Resuscitation and evaluation of non-beating hearts obtained from asphyxiated dogs via autoperfusing heart-lung circuit.

BACKGROUND: The shortage of donor hearts has made use of non-beating hearts as cardiac grafts an attractive possibility for heart transplant candidates. The purpose of this study was to evaluate the utility of leukocyte-depleted hot shot cardioplegia for resuscitation of non-beating hearts obtained from asphyxiated dogs via an autoperfusing heart-lung circuit. METHODS: Mongrel dogs were divided into 3 groups according to the warm ischemia time and the method of reperfusion before starting the autoperfusing heart-lung circuit. Group A (n=4) had 60 minutes of warm ischemia and reperfusion without leukocyte-depleted hot shot, Group B (n=5) had 30 minutes of warm ischemia and reperfusion with leukocyte-depleted hot shot, and Group C (n=7) had 60 minutes of warm ischemia and reperfusion with leukocyte-depleted hot shot. We calculated stroke work via the heart-lung circuit to evaluate cardiac function of the resuscitated hearts. The criteria for "recovery" has been reported elsewhere. Myocardial water content of the resuscitated hearts was also measured and analyzed. No inotropic agents were used. RESULTS: The recovery rates in groups A, B and C were 0%, 80% and 57%, respectively, and the group B rate was significantly higher than the group A rate (p=0.04). Although myocardial water content did not differ between groups B and C, it was significantly lower in recovered hearts than in non-recovered hearts (p=0.04). Significant negative correlation was observed between the maximum stroke work value and myocardial water content in the resuscitated hearts (r=0.668, p=0.03). CONCLUSIONS: The autoperfusing heart-lung circuit is useful for evaluation and maintenance of cardiac function. Our experimental data shows that leukocyte-depleted hot shot plays a great role for resuscitation and recovery of non-beating hearts.