The effect of graft perfusion with warm blood cardioplegia for cadaver heart transplantation |
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Authors: | Kotaro Suehiro Makoto Mohri Masami Takagaki Kunikazu Hisamochi Toru Morimoto Shunji Sano |
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Institution: | (1) Department of Cardiovascular Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, 700-8558 Okayama, Japan |
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Abstract: | This study was designed to verify the effect of reperfusion of donor hearts in a perfusion apparatus after 60 min of global
ischemia prior to heart transplantation. Thirteen dogs were exsanguinated from the femoral artery and cardiac arrest was achieved.
The hearts were left in situ at room temperature (25°C)for 60 min. In group A (n=7), the hearts were excised and reperfused 60 min after cardiac arrest in the perfusion apparatus with substrate-enriched
warm blood cardioplegia (WBCP) containing a hydroxyl radical scavenger, EPC, followed by 45 min of blood perfusion, Next,
the hearts were preserved in cold (4°C) University of Wisconsin (UW) solution. In group B (n=6), the hearts were perfused with cold (4°C) St. Thomas' solution 60 min after cardiac arrest and preserved in cold UW solution.
Thereafter, all hearts in both groups were transplanted orthotopically to recipient dogs. In group A, 6 of 7 dogs were weaned
from cardiopulmonary bypass (CPB). In group B, only 2 of 6 dogs were weaned from CPB. Moreover, 3 of the 6 hearts in group
B did not start beating after transplantation (stone heart). This study suggested reperfusion of the donor heart in the perfusion
apparatus with WBCP to be a beneficial preconditioning method when utilizing 60-min arrested hearts for transplantation.
This study was supported in part by Senju Pharmaceutical Co. Ltd., Osaka, Japan |
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Keywords: | heart transplantation cadaver heart reperfusion Emax stone heart |
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