Long-term cardiac preservation by the combined method of simple immersion and coronary perfusion

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The combined method of simple cold storage and coronary perfusion for prolonged preservation was evaluated through preservation and orthotopic transplantation using adult mongrel dogs (n=10,8-13kg). Following systemic heparinization, the donor heart was isolated by ligating the venae cavae and azygos vein, and cross-clamping the aorta. In situ initial flush for cooling and coronary vascular washout (20ml/kg) was performed via an aortic root with a University of Wisconsin (UW) solution. The heart was then removed and immersed into a cold (4ﾟC) UW solution. After 12-hr simple cold storage, 1-hr preservation was added by continuous coronary perfusion a 4ﾟC oxygenated UW solution (20ml/kg/hr). High energy phosphate (phosphocreatine ; PCr, and beta-adenosine triphosphate ; beta-ATP), inorganic phosphate (Pi) were measured by <@D131@>D1P-magnetic resonance spectroscopy (<@D131@>D1P-MRS) at (1) immediately after heart havesting, (2) after 12-hr cold storage, and (3) immediately after continuo … More us coronary perfusion. PCr and beta-ATP were decreased to 12.1(]SY.+-.])24.2% (mean(]SY.+-.[)SD), 37.4(]SY.+-.[)25.0%, respectively after 12-hr cold storage, and significantly increased to 94.0(]SY.+-.[)48.7% (p<0.001), 48.8(SY.+-.[)25.8% (p<0.05), respectively after 1-hr coronary perfusion. Disorder of nuclear arrangement and edema of muscular cells, which were observed after cold storage, were histologically restored after 1-hr coronary perfusion. Following orthotopic transplantation of preserved grafts, left ventricular (LV) pressure and LVdp/dt were evaluated in the recipient with 12-hr cold storage only (n=7, group A) and in the recient with 12-hr cold storage and 1-hr coronary perfusion (n=7, group B). LV pressure 2 hours after transplantation in group B were recovered to 76.1% significantly (p<0.01), compared with 51.9% in group A.Significantly higher values of LVdp/dt 2 hours after transplantation was observed in group B (83.0%) compared to group A (68.2%). These results indicate that the combined method of simple cold storage and coronary perfusion may be effective for myocardial protection during long-term preservation. Less