Document Detail

Continuous perfusion of donor hearts in the beating state extends preservation time and improves recovery of function.
MedLine Citation:
PMID:  9806389     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Improving methods of donor heart preservation may permit prolonged storage and remote procurement of cardiac allografts. We hypothesized that continuous, sanguineous perfusion of the donor heart in the beating, working state may prolong myocardial preservation. METHODS: We developed a portable perfusion apparatus for use in donor heart preservation. Contractile, metabolic, and vasomotor functions were monitored simultaneously in an isolated swine heart. The metabolic state was monitored by myocardial tissue pH. Vasomotor function was assessed in isolated coronary ring chambers. Hearts were randomized into 3 groups: group I (n = 5), cardioplegic arrest, 12-hour storage at 4 degrees C with modified Belzer solution, and 2-hour sanguineous reperfusion in the working state; group II (n = 6), 12-hour continuous perfusion in the beating working state, 30 minutes of arrest (to simulate re-implantation time), and 2 hours of reperfusion, as above; group III (n = 7), coronary ring control hearts. RESULTS: At 2 hours of reperfusion, left ventricular developed pressure in group II was higher than in group I (mean +/- standard deviation: 90 +/- 6 mm Hg, 53 +/- 15 mm Hg, P = .005). Significantly less myocardial edema was observed in group II than in group I (73% +/- 4%, 80% +/- 1% water content, P = .01). Significantly less myocardial acidosis was noted in group II than in group I during preservation (pH 7.3 +/- 0.01, 6.1 +/- 0.03, P < .001) and reperfusion (pH 7.3 +/- 0.008, 6.8 +/- 0.05, P < .001). Coronary endothelial vasomotor function was better preserved in group II than in group I as evidenced by dose-response relaxation of coronary rings to 10(-8) mol/L bradykinin (37%, 55% delta baseline, P = .01). CONCLUSION: This new method extends the current preservation limit and avoids time-dependent ischemic injury, thereby allowing for distant procurement of donor organs.
W H Hassanein; L Zellos; T A Tyrrell; N A Healey; M D Crittenden; V Birjiniuk; S F Khuri
Related Documents :
3999789 - Solutions for preservation of the heart at 0 degrees c.
22051849 - Myocardial performance and its acute response to angiotensin ii infusion in fetal sheep...
1554279 - Beyond cold cardioplegia.
14627909 - Mitochondrial permeability transition-pore inhibition enhances functional recovery afte...
22353149 - Measurement of the fetal isovolumetric contraction time in the fetus with a left ventri...
10875589 - Simultaneous antegrade and retrograde reperfusion after cardioplegic arrest for coronar...
17399809 - Coronary angiography in lebanon: use and overuse.
6982239 - Clinical factors influencing survival and adequacy of revascularization after coronary ...
3776939 - Cardiac involvement in congenital acquired immunodeficiency syndrome.
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  116     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-11-13     Completed Date:  1998-11-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  821-30     Citation Subset:  AIM; IM    
Department of Surgery, Brockton/West Roxbury Veterans Administration Medical Center, Harvard Medical School, Boston, Mass 02132, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Coronary Circulation / physiology
Energy Metabolism / physiology
Heart Arrest, Induced
Heart Transplantation / physiology*
Myocardial Contraction / physiology*
Myocardial Reperfusion Injury / physiopathology
Organ Preservation* / instrumentation
Tissue Survival / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Effect of development of antibodies to HLA and cytomegalovirus mismatch on lung transplantation surv...
Next Document:  Evidence of human non-alpha-galactosyl antibodies involved in the hyperacute rejection of pig lungs ...