title: Cardiac function after eight hour storage by using polyethylene glycol hemoglobin versus crystalloid perfusion.
abstract: Efforts to extend myocardial preservation for transplantation by crystalloid perfusion have been limited by edema and compromised function. We hypothesized that hypothermic perfusion preservation with a polyethylene glycol (PEG) conjugated hemoglobin solution may extend preservation times. The purpose of this study was to compare cardiac function after continuous perfusion by using a hypocalcemic, normokalemic crystalloid perfusate with and without the addition of PEG-hemoglobin (Hb). The hearts of 20 anesthetized and ventilated New Zealand White rabbits were harvested after cold cardioplegic arrest. Group I (n = 10) hearts were continuously perfused with a hypocalcemic, normokalemic 3% bovine PEG-Hb solution at 20 degrees C and 30 mm Hg for 8 hours. Group II (n = 10) hearts were continuously perfused with an identical crystalloid solution without PEG-Hb for 8 hours under the same conditions as group I hearts. Cardiac function was measured with a left ventricular force transducer after transfer to a standard crystalloid Langendorff circuit at 37 degrees C and an aortic root pressure of 59 mm Hg. After 8 hours of perfusion preservation, heart rate was similar for groups I and II (p = not significant [NS]). Coronary blood flow after and during preservation was similar between PEG-Hb and crystalloid preserved hearts (p = NS). Left ventricular developed pressure, peak dP/dt, and peak -dP/dt were superior in hearts preserved with PEG-Hb. Percent water of total ventricular weight was 82.0% for group I and 81.6% for group II (p = NS). Continuous perfusion preservation of rabbit hearts for 8 hours with a hypocalcemic normokalemic PEG-Hb based solution at 30 mm Hg and 20 degrees C yields left ventricular function that is superior to perfusion with a similar crystalloid solution without PEG-Hb, despite similar myocardial edema and coronary flow. Extended cardiac perfusion preservation with this PEG-Hb based solution deserves further study, including comparison with traditional cardioplegic preservation solutions.
authors.affiliation: Department of Pharmacology, UC Irvine Medical Center, Orange, California 92868, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Serna
authors.forename: L L
authors.initials: LL
authors.lastname: Powell
authors.forename: C
authors.initials: C
authors.lastname: Kahwaji
authors.forename: W C
authors.initials: WC
authors.lastname: Wallace
authors.forename: J
authors.initials: J
authors.lastname: West
authors.forename: G
authors.initials: G
authors.lastname: Cogert
authors.forename: P
authors.initials: P
authors.lastname: Smulowitz
authors.forename: E
authors.initials: E
authors.lastname: Steward
authors.forename: R E
authors.initials: RE
authors.lastname: Purdy
authors.forename: J C
authors.initials: JC
authors.lastname: Milliken
mesh_terms: D000818:Animals; D000077324:Crystalloid Solutions; D006321:Heart / Q000502:physiology*; D006454:Hemoglobins / Q000494:pharmacology*; D007552:Isotonic Solutions; D008297:Male; D009200:Myocardial Contraction; D009926:Organ Preservation; D010477:Perfusion; D010952:Plasma Substitutes / Q000494:pharmacology*; D011092:Polyethylene Glycols / Q000494:pharmacology*; D011817:Rabbits; D016277:Ventricular Function, Left
chemical_list: D000077324:Crystalloid Solutions; D006454:Hemoglobins; D007552:Isotonic Solutions; C109960:PEG-hemoglobin; D010952:Plasma Substitutes; D011092:Polyethylene Glycols