Continuous perfusion of donor hearts with oxygenated blood cardioplegia improves graft function

Donor hearts cannot be preserved beyond 6h using cold storage (CS). Improving preservation methods may permit prolonged storage of donor heart. We compared graft function in large animal model after prolonged preservation (8h) using continuous perfusion (CP) and CS method. Twenty-four miniature pigs were used as donors and recipients. Donor hearts were either stored in University of Wisconsin solution (UW solution) for 8h at 0-4°C (CS group, n=6) or were continuously perfused with oxygenated blood cardioplegia at 26°C for 8h (CP group, n=6). After preservation, hearts were transplanted into recipients and reperfused for 3h. Left ventricular (LV) function, cardiac output (CO), malondialdehyde (MDA) and adenosine triphosphate (ATP) levels, and water content were measured. Although water content of CP hearts was higher than that of CS, LV contractility and diastolic function of CP hearts were superior to those of CS. In addition, CP hearts performed better than CS hearts on CO in working heart state. ATP was better preserved and MDA levels were lower in CP hearts compared with those of CS (P<0.0001). Donor hearts can be preserved longer using continuous perfusion with oxygenated blood cardioplegia and this method prevents time-dependent ischemic injury.