Heart preservation and immunological tolerance induction in orthotopic heart transplantation in swines.

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Cyclophosphamide-induced immunological tolerance was further studied in various fully allogeneic murine combination, while a system of orthotopic heart transplantation was tried to established in swines by using cardiopulmonary bypass.Exp.1. When a recipient mouse was given 100mug anti Thy 1.2mAb i.v. on day-1,9x10^7 fully allogeneic spleen cells plus 3x10^7 bone narrow cells i.v. on day 0, and 200mg/kg cyclophosphamide on day 2, a long-lasting skin graft tolerance to the tolerogenic strain was induced in various fully allogeneic murine combinations such as C3H(H-2^k)*B6(H-2^b), B6*C3H, BALB(H-2^d)*B6, and BALB*C3H. The median survival (days) was 123 (n=19), 136(n=9), >503(n=15), and >165(n=8), respectively.Exp.2. Female swines (20-25kg) were used. Orthotopic heart transplantation was per-formed using cardiopulmonary bypass. The donor heart was arrested with Kyushu University cardioplegic solution (CP;Na87,K20)and then flushed with and emerged in the CP or in Collins' solution (C;Na10,K117). The preservation was performed at 0ﾟC for 4 hours. One hour after the aortic declamping, Emax was examined. Each group contained 5 pigs. Cardiopulmonary bypass was able to discontinue in 3(60%) in the CP group and in 1(20%) in the C group. Only one of the 3 of the CP group could be examined for Emax. LOS and bleeding was the major complications. Any long-term survivors were not obtained.