Gharagozloo F, Melendez F J, Hein R A, Shemin R J, DiSesa V J, Cohn L H
Department of Surgery, Harvard Medical School, Boston, Mass.
J Thorac Cardiovasc Surg. 1988 Jun;95(6):1008-13.
The applicability of heart transplantation remains limited in part by the inability to preserve the excised heart for long periods of time. Free radical scavengers have been shown to protect the anoxic myocardium by preventing damage to the cell membrane and may, therefore, be effective in extending successful preservation of donor hearts. We perfused 10 sheep hearts for 8 hours in an ex vivo perfusion system. The effect of superoxide dismutase combined with catalase, 60,000 units/L, was studied in five sheep, and five received placebo. Control determinations and determinations after 8 hours of preservation were obtained with the heart perfused with autologous blood at 37 degrees C at an aortic perfusion pressure of 60 mm Hg and flow of 180 to 200 ml/min. After control readings, the hearts were arrested and perfused with a cold (6 degrees to 8 degrees C) oxygenated buffered crystalloid solution with or without superoxide dismutase and catalase at a perfusion pressure of 30 cm H2O for 8 hours. Left and right ventricular compliance was measured sequentially with separate intraventricular balloons. After 8 hours of ex vivo preservation, hearts receiving superoxide dismutase and catalase had significantly better left and right ventricular performance, higher myocardial oxygen consumption, and lower lactate production than the control group. The hearts preserved with superoxide dismutase and catalase showed significantly better left and right ventricular compliance, much less increase in heart weight, and no change in the diastolic pressures. The results suggest that superoxide dismutase combined with catalase may be effective in extending ex vivo preservation of hearts for cardiac transplantation.
心脏移植的适用性在一定程度上仍受到限制，原因是无法长时间保存切除的心脏。自由基清除剂已被证明可通过防止细胞膜损伤来保护缺氧心肌，因此可能有效延长供体心脏的成功保存时间。我们在体外灌注系统中对10只绵羊心脏进行了8小时的灌注。研究了超氧化物歧化酶与60,000单位/升过氧化氢酶联合使用对5只绵羊的影响，另外5只接受安慰剂。在37摄氏度、主动脉灌注压60毫米汞柱、流量180至200毫升/分钟的条件下，用自体血液灌注心脏，获得对照测定值以及保存8小时后的测定值。对照读数后，使心脏停搏，然后用冷（6摄氏度至8摄氏度）的含氧缓冲晶体溶液灌注，该溶液含有或不含有超氧化物歧化酶和过氧化氢酶，灌注压力为30厘米水柱，持续8小时。使用单独的心室内球囊依次测量左心室和右心室顺应性。在体外保存8小时后，接受超氧化物歧化酶和过氧化氢酶的心脏与对照组相比，左心室和右心室功能明显更好，心肌耗氧量更高，乳酸生成更低。用超氧化物歧化酶和过氧化氢酶保存的心脏显示出左心室和右心室顺应性明显更好，心脏重量增加少得多，舒张压无变化。结果表明，超氧化物歧化酶与过氧化氢酶联合使用可能有效延长用于心脏移植的心脏的体外保存时间。
