Leukocyte depletion results in excellent heart-lung function after 12 hours of storage.
Extended preservation of the heart-lung block for 12 hours in a bovine model of heart-lung transplantation was achieved using donor core cooling, static hypothermic storage, and reperfusion on cardiopulmonary bypass with leukocyte-depleted (LD) blood. Orthotopic heart-lung transplantation was performed with (n = 4, LD group) or without (n = 4, control group) LD blood during cardiopulmonary bypass. Postoperative measurements of cardiopulmonary function were made at 2, 4, and 6 hours after reperfusion. Only 2 animals (50%) of the control group survived more than 2 hours, whereas all animals in the LD group survived the study period. Arterial oxygen tension on 100% oxygen was 535.63 +/- 64.96 mm Hg and 146.45 +/- 90.9 mm Hg in the LD and control groups, respectively, at 2 hours (p less than 0.5) and 524.3 +/- 73.32 and 147.9 +/- 255.67 mm Hg at 6 hours. Pulmonary artery systolic pressure-to-systemic pressure ratio was 0.49 +/- 0.08 and 0.62 +/- 0.35 at 2 and 6 hours in the LD group. Extravascular lung water was 17.81 +/- 0.02 mL/kg (control group) and 11.28 +/- 9.15 mL/kg (LD group) at 2 hours. At reperfusion, the mean neutrophil count was 27 +/- 27 and 764 +/- 635 x 10(9)/L in the LD and control groups, respectively. This novel approach of leukocyte depletion during reperfusion after heart-lung preservation resulted in excellent cardiac and pulmonary protection.
Pillai
R
R
Johns Hopkins Hospital, Baltimore, Maryland.
Bando
K
K
Schueler
S
S
Zebly
M
M
Reitz
B A
BA
Baumgartner
W A
WA
D000818:Animals; D000975:Antioxidants / Q000627:therapeutic use; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002417:Cattle; D003080:Cold Temperature; D005374:Filtration; D005609:Free Radicals; D016041:Heart-Lung Transplantation / Q000502:physiology*; D007958:Leukocyte Count; D007962:Leukocytes; D009504:Neutrophils / Q000502:physiology; D009926:Organ Preservation / Q000379:methods*; D015424:Reperfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000517:prevention & control*; D013997:Time Factors
D000975:Antioxidants; D005609:Free Radicals