title: Keeping donor hearts in completely beating status with normothermic blood perfusion for transplants.
abstract: BACKGROUND
  Previously, we reported the preservation method of donor hearts in an empty beating status with mild hypothermic perfusion. To completely avoid cardiac arrest and myocardial ischemia, we performed the beating preservation technique from procurement of hearts to transplants and assessed its efficacy for long-term preservation and feasibility for heart transplantation.
  
  
  METHODS
  Thirty-two swine donor hearts were preserved in beating status (group A, n = 8 pairs, perfused continuously with normothermic blood) or in static cold storage (group B, n = 8 pairs, stored in 4°C histidine-tryptophan-ketoglutarate solutions) for 8 hours. Then the donor hearts were implanted either in beating or static status. During transplantation, the incidence of arrhythmia, duration of anastomosis and cardiopulmonary bypass, and dosage of inotropic drugs were recorded. Hemodynamics of left ventricle and serum level of creatine kinase-MB were measured during transplantation. Myocardial ultrastructure was observed.
  
  
  RESULTS
  Compared with group B, in group A the anastomotic time was significantly longer, the cardiopulmonary bypass time was significantly shorter, the cardiac output was larger, and the incidence of arrhythmia, dosage of cardiovascular-active drugs, and serum level of creatine kinase-MB were lower. After declamping for 2 hours and 3.5 hours, the left ventricular hemodynamics of group A was significantly better than that of group B. The myocardial ultrastructure of group A was superior to that of group B.
  
  
  CONCLUSIONS
  Preservation of donor hearts in beating status with continuous, normothermic, blood perfusion is an effective approach for long-term preservation and is appropriate for heart transplantation.
authors: Department of Cardiothoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
authors: Yong
authors: Y
authors: Yang
authors: Hui
authors: H
authors: Lin
authors: Zhaoke
authors: Z
authors: Wen
authors: Ailan
authors: A
authors: Huang
authors: Guoyong
authors: G
authors: Huang
authors: Yanyan
authors: Y
authors: Hu
authors: Yonglong
authors: Y
authors: Zhong
authors: Baijun
authors: B
authors: Li
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D002302:Cardiac Output / Q000502:physiology*; D002315:Cardiopulmonary Bypass / Q000379:methods; D004195:Disease Models, Animal; D006084:Graft Rejection; D006085:Graft Survival; D006339:Heart Rate / Q000502:physiology*; D016027:Heart Transplantation / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D009200:Myocardial Contraction / Q000502:physiology; D015425:Myocardial Reperfusion / Q000379:methods; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D011897:Random Allocation; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D014019:Tissue Donors
chemical_list: D019188:Organ Preservation Solutions