A non-heart-beating donor model to evaluate functional and morphologic outcomes in resuscitated pig hearts.
A non-heart-beating donor model was considered to examine whether pig hearts from the abattoir could be resuscitated by whole blood reperfusion. For preservation, machine perfusion using University of Wisconsin (UW) solution was compared with storage on ice. Nineteen hearts from abattoir pigs, harvested 25 +/- 3 min after exsanguination, were harvested and transported to the laboratory. Controls (n = 7) were immediately reperfused with homologous whole pig blood in an isolated heart model for 60 min with monitoring of left ventricular developed pressure (LVDP), contractility, and coronary flow. UW solution hearts (UW, n = 6) were perfused for 4 h with 10 degrees C cold UW solution before blood reperfusion. In the cold storage group (CS, n = 6), the organs were stored for an additional 4 h on ice before blood reperfusion. In all hearts, histology was performed after 60 min of blood reperfusion to evaluate myocardial reperfusion injury. All three groups showed significant increases in LVDP (p <.001), although this functional recovery was earliest in the control group and latest in the UW group. Significant declines were observed for both LVDP and contractility from the peak values in each group to the end of blood reperfusion. Coronary flow increased steadily over the time course for the UW group, whereas in the control and CS groups flow increased during the first 15 min of blood reperfusion and then decreased. In the UW and CS groups, there were significant positive correlations between coronary flow and LVDP (p <.001). Microscopic examination revealed no differences between the three groups. Thus, hearts from an abattoir with 25 min of warm ischemic time can be resuscitated. For storage of these organs, continuous machine perfusion with UW solution is superior to cold storage on ice.
Department of Thoracic, Cardiac, and Vascular Surgery, Tübingen University Hospital, Tübingen, Germany. amscheule@yahoo.com
Albertus M
AM
Scheule
Jens
J
Haas
David
D
Zurakowski
Christian
C
Strotmann
Frauke
F
Michel
Ulrich
U
Vogel
Stephan
S
Miller
Hans P
HP
Wendel
Gerhard
G
Ziemer
D000241:Adenosine; D000493:Allopurinol; D000704:Analysis of Variance; D000818:Animals; D002314:Cardioplegic Solutions; D003326:Coronary Circulation / Q000502:physiology; D004867:Equipment Design; D005978:Glutathione; D006321:Heart / Q000502:physiology*; D006323:Heart Arrest; D016027:Heart Transplantation / Q000379:methods / Q000502:physiology; D066298:In Vitro Techniques; D007328:Insulin; D023421:Models, Animal; D015425:Myocardial Reperfusion / Q000295:instrumentation / Q000379:methods; D009206:Myocardium / Q000166:cytology; D019188:Organ Preservation Solutions; D011887:Raffinose; D012151:Resuscitation / Q000379:methods*; D013552:Swine; D013997:Time Factors; D014019:Tissue Donors; D016277:Ventricular Function, Left / Q000502:physiology
D002314:Cardioplegic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose