Kioka Y, Tago M, Bando K, Seno S, Shinozaki Y, Murakami T, Nawa S, Senoo Y, Teramoto S
J Heart Transplant. 1986 Nov-Dec;5(6):437-43.
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.
在实验1中,将用含有全氟化合物、钙拮抗剂和白蛋白的细胞内样溶液灌注24小时的供体心脏(C组)与在添加了钙拮抗剂的细胞内样溶液中浸泡24小时的心脏(B组)以及缺血时间少于1小时的心脏(A组)进行比较,随后进行原位心脏移植。在实验2中,使用含有(I组)和不含有(II组)全氟化合物和白蛋白的灌注液进行24小时离体心脏保存。在灌注过程中对心脏进行定期评估。实验1:所有移植心脏均自发开始跳动。三组之间在功能上无统计学显著差异。在保存结束时,C组的肌酸磷酸激酶和乳酸释放水平低于B组。电子显微镜检查显示,B组心肌的损伤比C组更严重。实验2:I组释放的肌酸磷酸激酶和乳酸脱氢酶水平低于II组。I组的乳酸浓度较低。在保存结束时,I组的丙酮酸浓度较高。II组心脏重量的增加比I组更明显。仅II组的被动顺应性降低。提示灌注法在24小时离体心脏保存方面优于浸泡法,且含有全氟化合物和白蛋白的灌注液是有用的。