Donor heart preservation in an empty beating state under mild hypothermia.
BACKGROUND
Cardiac surgery during an empty beating heart state has proven to be beneficial in myocardial protection. Based on this, we hypothesized that maintaining this state for donor heart preservation would have the same efficacy and a prolonged preservation period.


METHODS
Part 1: 12 pigs were divided into two groups (n = 6 per group). Donor hearts were preserved in group A by perfusion with leukocyte-depleted blood in the beating state, and in group B, in the traditional hypothermic static state with University of Wisconsin solution. After 8 hours, myocardial samples were obtained to detect myocardial edema, adenosine triphosphate, and ultrastructure. Part 2: 12 donor-recipient swine pairs were randomly allocated to either beating heart preservation with perfusion (group C) or traditional static preservation (group D). Donor hearts were stored for 8 hours after isolation, followed by implantation into recipient animals. Implanted hearts recovered for 120 minutes in an empty and beating state followed by 30 minutes in a working state, after which cardiac function was measured.


RESULTS
After preservation, myocardial adenosine triphosphate levels in group A were significantly higher than in group B. However, myocardial water content was not significantly different between these two groups. The damage of myocardial ultrastructure in group A was slight compared with that of group B. The experimental transplant group C showed excellent heart function after implantation when compared with group D.


CONCLUSIONS
Our study reveals greater effects of donor heart preservation in a beating state rather than simply with hypothermic storage in University of Wisconsin solution.
Lin
Hui
H
Department of Cardiothoracic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning City, China. guangxixiongwai@yahoo.com.cn
Mo
Ansheng
A
Zhang
Fan
F
Huang
Ailan
A
Wen
Zhaoke
Z
Ling
Shengjin
S
Hu
Yanyan
Y
Zhou
Yifang
Y
Lu
Changchao
C
D000818:Animals; D015925:Cryopreservation / Q000379:methods*; D004195:Disease Models, Animal; D004734:Energy Metabolism / Q000502:physiology; D006084:Graft Rejection; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D009200:Myocardial Contraction / Q000502:physiology; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011336:Probability; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013552:Swine; D014019:Tissue Donors
D019188:Organ Preservation Solutions