Long-term preservation of explanted hearts perfused with L-aspartate-enriched cardioplegic solution. Improved function, metabolism, and ultrastructure.
The effects of supplementing oxygenated St. Thomas' Hospital cardioplegic solution No. 2 with L-aspartate and/or D-glucose for the long-term preservation of excised rat hearts were determined with isolated working heart preparations. Left ventricular function was assessed at 37 degrees C with a crystalloid perfusate, before cardioplegic arrest and after 20 hours of low-flow perfusion (1.5 ml/min) with continuing arrest at 4 degrees C, and after this period, again at 37 degrees C with a crystalloid perfusate. Four groups (n = 8/group) of hearts were studied with four cardioplegic solutions: St. Thomas' Hospital solution alone, St. Thomas' Hospital solution with aspartate 20 mmol/L, St. Thomas' Hospital solution with glucose 20 mmol/L, and St. Thomas' Hospital solution plus both aspartate and glucose (20 mmol/L each). The addition of glucose to St. Thomas' Hospital solution made no significant difference in the recovery of aortic flow rates (17.7% +/- 8.6% and 21.6% +/- 7.8% of prearrest values), but when aspartate or aspartate and glucose were present, hearts showed significant improvements (89.8% +/- 5.2% and 85.0% +/- 6.2%, respectively). These improvements were associated with a reduction in the decline of myocardial high-energy phosphates during reperfusion, a reduction in cellular uptake of Na+ and Ca++, and a reduction in ultrastructural damage. These results indicate that low-flow perfusion with St. Thomas' Hospital solution plus aspartate can considerably extend the duration of safe storage of explanted hearts.
Choong
Y S
YS
Department of Pathology, University of Auckland School of Medicine, New Zealand.
Gavin
J B
JB
Buckman
J
J
D000227:Adenine Nucleotides / Q000378:metabolism; D000818:Animals; D001224:Aspartic Acid; D001639:Bicarbonates; D001834:Body Water / Q000378:metabolism; D002122:Calcium Chloride; D002314:Cardioplegic Solutions; D004573:Electrolytes / Q000378:metabolism; D006321:Heart / Q000503:physiopathology*; D016027:Heart Transplantation; D008274:Magnesium; D008297:Male; D009206:Myocardium / Q000378:metabolism* / Q000648:ultrastructure; D009926:Organ Preservation; D011189:Potassium Chloride; D051381:Rats; D011919:Rats, Inbred Strains; D012965:Sodium Chloride; D013997:Time Factors
D000227:Adenine Nucleotides; D001639:Bicarbonates; D002314:Cardioplegic Solutions; D004573:Electrolytes; C041711:St. Thomas' Hospital cardioplegic solution; D001224:Aspartic Acid; D012965:Sodium Chloride; D011189:Potassium Chloride; D008274:Magnesium; D002122:Calcium Chloride