[Cardiopulmonary bypass of orthotopic heart transplantation]

To summarize the extracorporeal circulation(ECC) management experiences on 4 cases of orthotopic heart transplantation.

All patients received moderate hypothermia and high flow rate perfusion. Many strategies were taken to maximize the protection of myocardium, lung, kidney and blood conservation. The donor hearts were arrested with aorto perfusion using modified St. Thomas solution at 4 degrees C. After being flushed with 5,000 mL cold saline, the donor hearts were perfused with 1,000 mL UW solution in 4 degrees C and preserved in ice saline. Ice mud was covered on the donor heart and cold saline was dripped into left atrium in the period of anastomosis.

The ECC time was 133.3+/-13.1 min, and the warm and cold ischemia time was respectively 1-3 min and 142.0+/-28.2 min. All the cases recovered heart beats automatically. Left ventricular ejection fractions were 60%-65% a month postoperatively. One patient died of acute rejection 150 days postoperatively. 3 cases survived.

Proper ECC management, importment organs and donor heart protection are the key to success in heart transplant operations.