Details

Autor(en) / Beteiligte

• Cope, Jeffrey T.
• Mauney, Michael C.
• Banks, David
• Binns, Oliver A.R.
• De Lima, Nuno F.
• Buchanan, Scott A.
• Shockey, Kimberly S.
• Wilson, Shawn W.
• Kron, Irving L.
• Tribble, Curtis G.

Titel

Controlled reperfusion of cardiac grafts from non-heart-beating donors

Ist Teil von

• The Annals of thoracic surgery, 1996-11, Vol.62 (5), p.1418-1423

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

1996

Quelle

MEDLINE

Beschreibungen/Notizen

• Hearts harvested from non-heart-beating donors sustain severe injury during procurement and implantation, mandating interventions to preserve their function. We tested the hypothesis that limiting oxygen delivery during initial reperfusion of such hearts would reduce free-radical injury. Rabbits sustained hypoxic arrest after ventilatory withdrawal, followed by 20 minutes of in vivo ischemia. Hearts were excised and reperfused with blood under conditions of high arterial oxygen tension (PaO 2) (approximately 400 mm Hg), low PaO 2 (approximately 60 to 70 mm Hg), high pressure (80 mm Hg), and low pressure (40 mm Hg), with or without free-radical scavenger infusion. Non—heart-beating donor groups were defined by the initial reperfusion conditions: high PaO 2/high pressure (n = 8), low PaO 2/high pressure (n = 7), high PaO 2/low pressure (n = 8), low PaO 2/low pressure (n = 7), and high PaO 2/high pressure/free-radical scavenger infusion (n = 7). After 45 minutes of reperfusion, low PaO 2/high pressure and high PaO 2/low pressure had a significantly higher left ventricular developed pressure (63.6 ± 5.6 and 63.1 ± 5.6 mm Hg, respectively) than high PaO 2/high pressure (40.9 ± 4.5 mm Hg; p < 0.0000001 versus both). However, high PaO 2/high pressure/free-radical scavenger infusion displayed only a trend toward improved ventricular recovery compared with high PaO 2/high pressure. Initially reperfusing nonbeating cardiac grafts at low PaO 2 or low pressure improves recovery, but may involve mechanisms other than decreased free-radical injury.