• J. Heart Lung Transplant. · Jul 2010

    Comparative Study

    Cardiac reanimation for donor heart transplantation after cardiocirculatory death.

    • Stephen Repse, Salvatore Pepe, James Anderson, Catriona McLean, and Franklin L Rosenfeldt.
    • Department of Cardiothoracic Surgery, Alfred Hospital, Prahan, Australia.
    • J. Heart Lung Transplant. 2010 Jul 1; 29 (7): 747-55.

    BackgroundThis study was conducted in donor hearts obtained after cardiocirculatory death (DCD) to determine whether pre-reperfusion cardioplegia, followed by warm blood perfusion, is superior to cold storage in preserving function sufficient for transplantation.MethodsGreyhound dogs (n = 15) were anesthetized and cardiocirculatory death and circulatory failure was induced by cessation of mechanical ventilation. After 30-minutes, the hearts were preserved by perfusion or were infused with modified St. Thomas' cardioplegia, explanted, and stored for 4 hour at 4 degrees C. Perfusion hearts were briefly reperfused with an acidic, mitochondrial protective cardioplegic solution and then continuously perfused for 4 hours with normothermic blood. Hearts from a normal reference group (no cardiocirculatory arrest) were preserved by St. Thomas' cardioplegia and cold storage. In all groups, 40 minutes of room temperature ischemia was used to simulate the conditions of transplantation. Final functional and metabolic assessments were made on a working heart apparatus.ResultsPerfusion hearts (n = 6), when compared with cold storage hearts (n = 6), produced a greater rate of change in left ventricular pressure (1121 +/- 273 vs 336 +/- 193 mm Hg/sec, p = 0.04), greater echocardiographic fractional area reduction (71.3% +/- 10.0% vs 25.4% +/- 2.9% of baseline, p = 0.004) and lower perfusate lactate levels (1.5 +/- 1.4 vs 9.7 +/- 1.4 mmol/liter; p = 0.002). Functional recovery in perfusion hearts was comparable to the normal hearts (n = 3).ConclusionFor DCD hearts, a strategy of pre-reperfusion cardioplegia, followed by continuous warm blood perfusion, is superior to cold storage. These results suggest DCD hearts may be more suitable for transplantation after continuous warm blood perfusion than after cold storage.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…