A comparative study of long-term heart preservation using 12-h continuous coronary perfusion versus 1-h coronary perfusion following 11-h simple immersion.
OBJECTIVE
We previously reported the superiority of the continuous coronary perfusion method using apparatus developed in our department. However, myocardial edema was a serious problem following this method. The purpose of this study was to attempt a comparative study of 12-h continuous perfusion and 1-h perfusion following 11-h simple immersion to evaluate the suitable method for long-term heart preservation.


METHODS
HBD dogs were used in this study. After measuring baseline hemodynamics, cardiac arrest was attained and the coronary vascular beds were washed out with 4 degrees C Celsior solution. The grafts were divided into the two groups. In the CP group (n = 6), the grafts were preserved by continuous perfusion with 4 degrees C Celsior solution, and in the SI + CP (n = 6) group, the grafts were preserved with 11 h of simple immersion followed by an additional 1 h of perfusion with the same solution. The hemodynamics after orthotopic transplantation were compared. We also performed a histopathologic examination.


RESULTS
Hemodynamics after reperfusion were maintained in both groups, and there were no significant differences in CO, Emax, or the rate pressure product between the two groups. In contrast, the percentage water content was significantly lower in the SI + CP group than in the CP group. Histopathologically, the myocytes were well preserved in both groups. However, ischemia-reperfusion changes were observed more frequently in the CP group than in the SI + CP group.


CONCLUSIONS
A short-term perfusion following the simple immersion method may provide satisfactory results compared to the continuous perfusion method in long-term heart preservation.
Nameki
Taro
T
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, Japan.
Takeyoshi
Izumi
I
Oshima
Kiyohiro
K
Kobayashi
Katsumi
K
Sato
Hiroaki
H
Matsumoto
Koshi
K
Morishita
Yasuo
Y
D000818:Animals; D002302:Cardiac Output; D004187:Disaccharides; D004285:Dogs; D004487:Edema / Q000473:pathology / Q000517:prevention & control; D004573:Electrolytes; D005971:Glutamates; D005978:Glutathione; D006085:Graft Survival; D016027:Heart Transplantation; D006639:Histidine; D008353:Mannitol; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009926:Organ Preservation / Q000295:instrumentation / Q000379:methods*; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000295:instrumentation / Q000379:methods*; D015427:Reperfusion Injury / Q000473:pathology / Q000517:prevention & control*; D014867:Water / Q000378:metabolism
C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; D005971:Glutamates; D019188:Organ Preservation Solutions; D014867:Water; D008353:Mannitol; D006639:Histidine; D005978:Glutathione