Low-flow perfusion of guinea pig isolated hearts with 26°C air-saturated Lifor solution for 20 hours preserves function and metabolism
Low-flow perfusion of guinea pig isolated hearts with 26°C air-saturated Lifor solution for 20 hours preserves function and metabolism
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DOI：
10.1016/j.healun.2008.05.028
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发表时间：
2008-09-01
影响因子：
8.9
通讯作者：
Harder, David R.
中科院分区：
文献类型：
--
作者：
Stowe, David F.;Camara, Amadou K. S.;Harder, David R.
背景：供体心脏从移植到受体心脏植入之间不能保存超过5小时。需要一种更好的方法来更长时间地保存可移植的心脏，最好是在运输的环境条件下。我们测试了Lifor溶液是否可以令人满意地保存豚鼠离体心脏在低流量，不加氧，在室温下灌注20 h.Methods：心脏分离自18只豚鼠，并在37 ° C的氧合Krebs-Ringer（KR）溶液初始灌注。然后在26 ℃下用再循环的Lifor或心脏停搏液（CP）溶液（K+ 15 mmol/L）灌注心脏20小时，所述溶液用20%控制流量的室内空气平衡。心脏，然后灌注在100%流量与KR在37 ℃下2小时。结果：Lifor和CP逮捕所有的心脏。在使用Lifor进行20小时低流量灌注期间，冠状动脉压增加了6 +/- 2 mm Hg，氧提取百分比增加了29 +/-2%，而耗氧量（MVO 2）减少了74 +/-4%。CP观察到类似的变化，但MVO 2降低了86 +/-7%。Lifor低流量灌注20 h，KR液温灌注2 h后，左室舒张压（LVP）、最大dLVP/dt和氧摄取率完全恢复至基线值，心率恢复至80 ± 3%，左室舒张压为76 3%，最小dLVP/dt（舒张）至65 4%，冠状动脉流量至80 +/-4%，耗氧量至82 +/- 4%，心脏效率至基线值的85 +/- 4%。Lifor治疗后对腺苷和硝普钠的血流反应分别为基线值的65 +/- 3%和64 +/- 3%。心脏停搏后，治疗有没有心脏活动，舒张压为35 +/- 14毫米汞柱和冠状动脉流量的回报，只有45 +/- 3%的基线value.Conclusions：与心脏停搏液在环境空气和温度条件下，Lifor解决方案是一个更好的介质，在这个模型中的长期心脏保存。
Background: Donor human hearts cannot be preserved for >5 hours between explantation and recipient implantation. A better approach is needed to preserve transplantable hearts for longer periods, ideally at ambient conditions for transport. We tested whether Lifor solution could satisfactorily preserve guinea pig isolated hearts perfused at low flow with no added oxygen at room temperature for 20 hours.Methods: Hearts were isolated from 18 guinea pigs and perfused initially with oxygenated Krebs-Ringer (KR) solution at 37 degrees C. Hearts were then perfused with recirculated Lifor or cardioplegia (CP) solution (K+ 15 mmol/liter) equilibrated with room air at 20% of control flow at 26 degrees C for 20 hours. Hearts were then perfused at 100% flow with KR for 2 hours at 37 degrees C.Results: Lifor and CP arrested all hearts. During the 20-hour low-flow perfusion with Lifor coronary pressure increased by 6 +/- 2 mm Hg and percent oxygen extraction by 29 +/- 2%, whereas oxygen consumption (MVO2) decreased by 74 +/- 4%. Similar changes were noted for CP, except that MVO2 was decreased by 86 +/- 7%. After 20-hour low-flow perfusion with Lifor and 2 hours of warm reperfusion with KR solution, diastolic left ventricular pressure (LVP), maximal dLVP/dt and percent oxygen extraction returned completely to baseline values, whereas heart rate returned to 80 +/- 3%, developed LVP to 76 3%, minimal dLVP/dt (relaxation) to 65 4%, coronary flow to 80 +/- 4%, oxygen consumption to 82 +/- 4% and cardiac efficiency to 85 +/- 4% of baseline values., Flow responses to adenosine and nitroprusside after Lifor treatment were 65 +/- 3% and 64 +/- 3% of their baseline values. After cardioplegia, treatment there was no cardiac activity, with a diastolic pressure of 35 +/- 14 mm Hg and a return of coronary flow to only 45 +/- 3% of baseline value.Conclusions: Compared with a cardioplegia solution at ambient air and temperature conditions, Lifor solution is a much better medium for long-term cardiac preservation in this model.