Twenty-four-hour isolated heart preservation by perfusion method with oxygenated solution containing...

In Experiment 1 the donor hearts (group C) perfused for 24 hours with an intracellular-like solution containing perfluorochemicals, calcium antagonist, and albumin were compared with the hearts immersed for 24 hours in an intracellular-like solution to which calcium antagonist was added (group B) and the hearts in which the ischemic time was less than 1 hour (group A) followed by orthotopic heart transplantation. In Experiment 2 perfusates with (group I) and without (group II) perfluorochemicals and albumin were used for 24-hour isolated heart preservation. Periodic assessment of the hearts was performed during the perfusion. Experiment 1: All transplanted hearts started beating spontaneously. There was no statistically significant functional difference between the three groups. At the end of the preservation the creatinine phosphokinase and lactate releases of group C were at lower levels than those in group B. Electron microscopic examination revealed that the myocardium in group B was damaged more severely than in group C. Experiment 2: The level of the creatinine phosphokinase and lactate dehydrogenase released in group I was lower than that in group II. The lactate concentration was at a lower level in group I. At the end of the preservation the pyruvate concentration was higher in group I. The gain in heart weight in group II was more marked than that in group I. The passive compliance decreased only in group II. It is suggested that the perfusion method is superior to the immersion method for 24-hour isolated heart preservation and that the perfusate containing perfluorochemicals and albumin is useful.