Document Detail

Prediction of functional recovery of 60-minute warm ischemic hearts from asphyxiated canine non-heart-beating donors.
MedLine Citation:
PMID:  16507429     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiac function of non-heart-beating donors (NHBDs) is uncertain due to severe myocardial damage. We developed an isolated myocardial perfusion system to resuscitate NHBD hearts and attempted to predict functional recovery of 60-minute warm ischemic hearts by analyzing systolic and diastolic functions. METHODS: Hypoxic cardiac arrest was induced in 8 mongrel dogs without any pre-treatments. After 60-minute ischemia, intracoronary microthrombi were flushed out by retrograde blood cardiopledia with tissue-type plasminogen activator. Coronary arteries were initially perfused from the aortic root with tepid hyperkalemic blood (20 mmol/liter) at low pressure (20 mm Hg) for the first 60 minutes and then with normothermic blood for the next 60 minutes. After 120 minutes of reperfusion, pre-load was increased for ejection against an after-load of 80 mm Hg. Pressure-volume loops were recorded to obtain the end-systolic pressure-volume relationship (ESPVR) and end-diastolic pressure-volume relationship (EDPVR). Stroke volume at a given pre-load was calculated from averaged ESPVR, EDPVR and after-load identical to an averaged baseline value. The Frank-Starling relationship was obtained and cardiac status was classified according to Forrester's hemodynamic sub-set. RESULTS: End-systolic elastance decreased significantly to about 60% of baseline and the time constant of isovolumic relaxation was prolonged significantly by about 20%. Cardiac index was decreased to about 50% and cardiac status was classified in the Forrester III or IV sub-set. CONCLUSIONS: The extent of functional recovery of NHBD hearts is predictable by cardiac output. Although 120 minutes of recovery time may be short for 60-minute ischemic damage, this system may be feasible to predict post-transplant cardiac function before transplantation.
Masanori Hirota; Kozo Ishino; Ichiro Fukumasu; Kazuhiro Yoshida; Satoshi Mohri; Juichiro Shimizu; Fumihiko Kajiya; Shunji Sano
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Publication Detail:
Type:  Journal Article     Date:  2006-01-25
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  25     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-01     Completed Date:  2006-06-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-44     Citation Subset:  IM    
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
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MeSH Terms
Blood Pressure
Heart Arrest / chemically induced
Heart Arrest, Induced / methods
Heart Transplantation
Myocardial Ischemia / physiopathology*
Myocardial Reperfusion / methods*
Organ Preservation / methods*
Ventricular Function, Left / physiology

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