The effect of short-term coronary perfusion using a perfusion apparatus on canine heart transplantation from non-heart-beating donors.
BACKGROUND
We investigated the effects of briefly perfusing hearts from non-heart-beating donors (NHBDs) with a Celsior solution before cardiac transplantation.


METHODS
Donor hearts were left in situ for 20 minutes after cardiac arrest was induced by rapid exsanguination. Twelve donor-recipient pairs of mongrel dogs were divided into 2 groups, the simple immersion (SI, n = 6) group and the coronary perfusion (CP, n = 6) group. Both groups underwent coronary flushing with Celsior, after which hearts from the SI group were stored using simple immersion for 4 hours and hearts from the CP group underwent 1 hour of further perfusion followed by storage for 3 hours. Orthotopic transplantation was then performed. We measured cardiac output, end-systolic maximal elastance (E(max)), left ventricular pressure, and rate pressure product 1 and 2 hours after weaning from cardiopulmonary bypass (CPB). Two hours after weaning from CPB, the hearts were harvested for histopathologic study and to determine the percentage of water content.


RESULTS
The cardiac output (CO) recovery rate was significantly higher in the CP group than in the SI Group 1 hour after weaning from CPB (p < 0.05). The CO recovery rate, E(max), and rate pressure product were significantly higher and the percentage of water content was significantly lower in the CP group than in the SI Group 2 hours after weaning from CPB (p < 0.05). Histopathologic damage was more severe in the SI group.


CONCLUSIONS
The results of this study suggest that short-term coronary perfusion with a Celsior solution may be useful for heart transplantation from NHBDs.
Koike
Norimasa
N
Second Department of Surgery, Gunma University School of Medicine, Maebashi, Gunma, Japan.
Takeyoshi
Izumi
I
Ohki
Shigeru
S
Tsutsumi
Hirofumi
H
Matsumoto
Koshi
K
Morishita
Yasuo
Y
D000818:Animals; D002302:Cardiac Output / Q000502:physiology; D002315:Cardiopulmonary Bypass; D004195:Disease Models, Animal; D004285:Dogs; D004554:Electric Countershock; D004804:Eosinophils / Q000378:metabolism; D006324:Heart Arrest, Induced / Q000009:adverse effects; D016027:Heart Transplantation; D008929:Mitochondria, Heart / Q000378:metabolism / Q000473:pathology; D008955:Models, Cardiovascular; D009200:Myocardial Contraction / Q000502:physiology; D015425:Myocardial Reperfusion; D032383:Myocytes, Cardiac / Q000378:metabolism / Q000473:pathology; D009926:Organ Preservation; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D017725:Ventricular Pressure / Q000502:physiology; D014882:Water-Electrolyte Balance / Q000502:physiology