title: Total recovery of heart grafts of non-heart-beating donors after 3 hours of hypothermic coronary oxygen persufflation preservation in an orthotopic pig transplantation model.
abstract: BACKGROUND
  The coronary oxygen persufflation (COP) technique has been previously shown to allow prolonged heart preservation of 14 hr with optimal recovery in a pig model of orthotopic transplantation. This technique may be applicable to hearts grafted from non-heart-beating donors (NHBD).
  
  
  METHODS
  Experiments were performed on pigs to test the effectiveness of oxygenated preservation, using COP for preservation of NHBD hearts. After 16 min of in situ normothermic ischemia, the hearts were flushed with histidine-tryptophan-ketoglutarate (HTK) solution or modified HTK solution (mBHTK) including 30 mmol/L 2,3-butanedione monoxime, 40 mg/L hyaluronidase,15 micromol/L adenosine, and 50 micromol/L calcium. Hearts were stored in the flush solutions for 3.3 hr or additionally persufflated with gaseous oxygen through the coronary arteries (COP) and transplanted orthotopically.
  
  
  RESULTS
  Simple storage in HTK did not allow recovery of these hearts, whereas mBHTK storage resulted in improved function with 1.1 L/min cardiac output. The cardiac output reached 2.8 L/min (68% of normal values) with a left ventricular developed pressure of 101 mm Hg only after mBHTK+COP. Then the hearts were able to guarantee the circulation of the recipient for the test period after weaning from the heart-lung machine.
  
  
  CONCLUSIONS
  Even in an NHBD with more than 15 min of in situ ischemia, the use of COP in combination with mBHTK solution for 3.3-hr storage of the heart allows excellent recovery of transplanted hearts and normal weaning from the heart-lung machine. This indicates that COP combined with mBHTK may be an optimal preservation technique for use with NHBD hearts.
authors.affiliation: Second Department of Surgery, Kagoshima University, Kagoshima, Japan.
authors.forename: Goichi
authors.initials: G
authors.lastname: Yotsumoto
authors.forename: Stephanie
authors.initials: S
authors.lastname: Jeschkeit-Schubbert
authors.forename: Claudia
authors.initials: C
authors.lastname: Funcke
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Kuhn-Régnier
authors.forename: Jürgen Hartmut
authors.initials: JH
authors.lastname: Fischer
mesh_terms: D000818:Animals; D003931:Diacetyl / Q000031:analogs & derivatives* / Q000494:pharmacology; D005947:Glucose / Q000494:pharmacology; D006323:Heart Arrest; D016027:Heart Transplantation; D006355:Heart-Lung Machine; D007036:Hypothermia, Induced; D008353:Mannitol / Q000494:pharmacology; D017202:Myocardial Ischemia / Q000378:metabolism; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism*; D019188:Organ Preservation Solutions / Q000494:pharmacology; D010100:Oxygen / Q000378:metabolism*; D011189:Potassium Chloride / Q000494:pharmacology; D011343:Procaine / Q000494:pharmacology; D013552:Swine; D014021:Tissue Preservation
chemical_list: C039984:Bretschneider cardioplegic solution; D019188:Organ Preservation Solutions; C004717:diacetylmonoxime; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose; D003931:Diacetyl; D010100:Oxygen