作者
CW White, A Ali, D Hasanally
简介
Background: Ex vivo heart perfusion (EVHP) has been proposed as a means to facilitate there suscitation of donor hearts after cardiocirculatory death (DCD) and increase the donor pool. However, the current approach to clinical EVHP may exacerbate myocardial injury and impair function after transplant. Therefore, we sought to determine if a cardioprotective EVHP strategy that eliminates myocardial exposure to hypothermic hyper-kalemia cardioplegia and minimizes cold ischemia could facilitate successful DCD heart transplantation.
METHODS: Anesthetized pigs sustained a hypoxic cardiac arrest and a15-minute warm ischemic standoff period. Strategy 1 hearts (S1, n= 9) underwent initial reperfusion with a cold hyperkalemic cardioplegia, normothermic EVHP, and transplantation after a cold hyperkalemic cardioplegic arrest (current EVHP strategy). Strategy 2 hearts (S2, n= 8) underwent initial reperfusion with a …