title: Enhanced 24-hour in vitro heart preservation with adenosine and adenosine monophosphate.
abstract: Continuous hypothermic perfusion is an effective means of preserving ex vivo cardiac allografts. Using canine hearts, we assessed the ability of the high-energy phosphate precursors adenosine and adenosine monophosphate to enhance the protective effect of continuous hypothermic perfusion. Group 1 hearts (controls) were perfused for 24 hours with a modified Krebs-Henseleit solution. Group 2 hearts were perfused with control perfusate to which adenosine was added (20 mumol/L). Group 3 hearts were perfused with control perfusate with adenosine monophosphate (0.1 mmol/L). After perfusion heart weights increased similarly in all groups. Coronary vascular resistance increased during the preservation period in group 1 hearts, but decreased in groups 2 and 3 hearts. Developed pressures were 103 +/- 22 mm Hg in group 1, 163 +/- 27 mm Hg in group 2 (p less than 0.01), and 141 +/- 34 mm Hg (p less than 0.05) in group 3. The rate of pressure development in group 2 (2143 +/- 249 mm Hg) and group 3 (2059 +/- 395 mm Hg) hearts was significantly greater than in group 1 hearts (1434 +/- 363 mm Hg, p less than 0.01). Only group 3 myocardial adenosine triphosphate levels were significantly greater than controls (3.18 +/- 0.52 mumol/gm vs 2.12 +/- 0.74 mumol/gm, p less than 0.05) on completion of perfusion. Myocardial lactate levels at this time were significantly higher in group 1 hearts (7.48 +/- 3.96 mumol/gm) compared with groups 2 and 3 (0.34 +/- 0.58 mumol/gm and 1.50 +/- 0.91 mumol/gm, respectively, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Cardiovascular Research Unit, Royal Victoria Hospital, Montreal, Quebec, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Petsikas
authors.forename: M A
authors.initials: MA
authors.lastname: Ricci
authors.forename: R
authors.initials: R
authors.lastname: Baffour
authors.forename: B
authors.initials: B
authors.lastname: de Varennes
authors.forename: J
authors.initials: J
authors.lastname: Symes
authors.forename: A
authors.initials: A
authors.lastname: Guerraty
mesh_terms: D000241:Adenosine / Q000494:pharmacology*; D000249:Adenosine Monophosphate / Q000494:pharmacology*; D000818:Animals; D004285:Dogs; D005260:Female; D006321:Heart / Q000187:drug effects / Q000502:physiology*; D016027:Heart Transplantation / Q000502:physiology; D008297:Male; D009206:Myocardium / Q000378:metabolism; D009926:Organ Preservation / Q000379:methods*; D012996:Solutions; D014184:Transplantation, Homologous
chemical_list: D012996:Solutions; D000249:Adenosine Monophosphate; D000241:Adenosine