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Long-term neonatal heart preservation.

H G Davtyan1, A F Corno, H Laks

  • 1Department of Cardiothoracic Surgery, UCLA Medical Center 90024.

The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1988
PubMed
Summary
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Neonatal hearts stored for 12 hours showed poor recovery with normal blood reperfusion. Modified blood reperfusion, especially with Sacks plus glucose storage solution and free radical scavengers, enabled complete functional recovery, making extended preservation feasible.

Area of Science:

  • Cardiovascular Surgery
  • Organ Transplantation
  • Neonatal Medicine

Background:

  • Donor availability is a critical limitation for neonatal heart transplantation.
  • Extending donor heart preservation time is essential for facilitating distant organ procurement.

Purpose of the Study:

  • To evaluate methods for prolonging the preservation time of neonatal donor hearts.
  • To assess the impact of different cardioplegic, storage, and reperfusion solutions on neonatal heart function after 12-hour hypothermic storage.

Main Methods:

  • Neonatal piglet hearts (n=42) underwent 12-hour hypothermic storage (4°C) using various cardioplegic and storage solutions.
  • Hearts were reperfused with either normal or modified blood containing oxygen-derived free radical scavengers.
  • Functional recovery was assessed using an isolated, blood-perfused, working heart preparation, measuring stroke work index.

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Main Results:

  • Normal blood reperfusion resulted in poor recovery (8-11%).
  • Modified blood reperfusion significantly improved recovery (37-115%).
  • Optimal recovery (115%) was achieved with the Sacks plus glucose storage solution and modified blood reperfusion including high concentrations of catalase and superoxide dismutase.

Conclusions:

  • Neonatal hearts stored hypothermically for 12 hours have limited tolerance to normal blood reperfusion.
  • Modified blood reperfusion, particularly with oxygen-derived free radical scavengers, markedly enhances functional recovery.
  • Complete functional recovery of neonatal hearts after 12-hour preservation is achievable, demonstrating the feasibility of extended preservation.