Basic principles of cardioplegic management in donor heart preservation.

The primary factor limiting the number of heart transplantation performed is the lack of adequate donor hearts. One of the main factors contributing to this is the relatively short period a donor heart can be preserved. Clinical studies demonstrate that ischemic times over five hours lead to early heart failure after transplantation. A considerable increase in preservation time would be necessary to enlarge the donor pool. In spite of intensive research, it is not yet possible to increase the preservation period above four hours, which was achieved in 1978. An increase of the cold ischemia period to more than four hours without the risk of transplanted heart damage may only be achieved by improving cardioplegic management.