Twelve-hour cardiopulmonary preservation using donor core cooling, leukocyte depletion, and liposomal superoxide dismutase.
Because leukocytes and oxygen radical species contribute to ischemic and reperfusion injury during organ preservation, we examined the effects of a long-acting liposomal superoxide dismutase (liposomal SOD) and mechanical filtration of leukocytes on cardiopulmonary graft function after 12 hours of static preservation. Bovine heart-lung blocks were harvested, core cooled to 15 degrees C, stored in 4 degrees C donor blood for 12 hours, and then orthotopically transplanted (control group, n = 6). In the leukocyte-depletion group (n = 6), a leukocyte filter was incorporated in the bypass circuits of the donor and recipient. In the SOD group (n = 6), liposomal SOD (5000 U/kg) was administered in the cardioplegic solution, in the prime of the bypass circuits of donor and recipient, and immediately before recipient heart-lung reperfusion. In the combination group (n = 6), both leukocyte depletion (LD) and liposomal SOD were used. Only four of six control animals survived more than 2 hours after weaning from bypass, whereas all LD, SOD, and LD + SOD animals survived to be studied at 6 hours. Pulmonary function was assessed at 6 hours by arterial oxygen tension on 100% inspired oxygen (PO2), pulmonary vascular resistance (PVR), and postmortem wet/dry lung weight ratios. Arterial pO2 values (mm Hg) were as follows: control, 102 +/- 51; LD, 437 +/- 60*; SOD, 278 +/- 83; and LD + SOD, 504 +/- 54* (*p less than 0.05 vs controls). PVR values (dynes . sec . cm5) were as follows: control, 1975 +/- 697; LD, 682 +/- 131*; SOD, 607 +/- 191*; and LD + SOD 367 +/- 87* (*p less than 0.05 vs controls).(ABSTRACT TRUNCATED AT 250 WORDS)
Bando
K
K
Division of Cardiac Surgery, Johns Hopkins Medical Institution, Baltimore, Md.
Schueler
S
S
Cameron
D E
DE
DeValeria
P A
PA
Hatanaka
M
M
Casale
A S
AS
Zebley
M A
MA
Hutchins
G M
GM
Reitz
B A
BA
Baumgartner
W A
WA
D000818:Animals; D002314:Cardioplegic Solutions; D002417:Cattle; D006321:Heart; D016041:Heart-Lung Transplantation; D008081:Liposomes; D008168:Lung; D008212:Lymphocyte Depletion; D009926:Organ Preservation / Q000379:methods*; D013482:Superoxide Dismutase / Q000008:administration & dosage; D013997:Time Factors
D002314:Cardioplegic Solutions; D008081:Liposomes; D013482:Superoxide Dismutase