[Experiences of cardiopulmonary bypass for heart transplantation].
OBJECTIVE
To summarize the experiences of cardiopulmonary bypass (CPB) techniques in 15 patients of orthotopic heart transplantation.


METHODS
All patients received mild hypothermia and high flow rate perfusion. Effective strategies were taken to protect myocardium, lung, kidney, and blood conservation. The donor hearts were arrested with aorto perfusion using 1 000 ml St. Thomas solution at 4 degrees C, perfused with 1 000 ml University of Wiscosin (UW) solution or Histidin-Tryptophan-Ketoglutarat (HTK) solution at 4 degrees C, and then preserved in ice saline. Ice mud was covered on the donor heart during anastomosis. Low potassium cardioplegia solution was perfused before the unclamping of aorta.


RESULTS
The CPB time was (165.2 +/- 22. 8) min, the warm ischemia time was ( 7. 7 +/- 1. 7) min, and the cold ischemia time was ( 142. 4 +/- 11. 5) min. Heart beats was automatically recovered in 10 patients, and was recovered upon defibrillation in 5 patients. Left ventricular ejection fractions were (64. 1 +/- 4. 6) % after one month. All patients survived.


CONCLUSIONS
Proper CPB management and effective donor heart protection are essential to guarantee the success of heart transplantation.
Hei
Fei-Long
FL
Department of Cardiopulmonary Bypass, Cardiovascular Institute and Fuwai Hospital, CAMS and PUMC, Beijing 100037, China. heifeilong@yahoo.com
Wang
Shi-Gang
SG
Long
Cun
C
D002315:Cardiopulmonary Bypass; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans