Illes R W, Asimakis G K, Inners-McBride K, Buckingham E D
University of Texas Medical Branch, Division of Cardiothoracic Surgery, Galveston, USA.
J Heart Lung Transplant. 1995 May-Jun;14(3):553-61.
Use of hearts from non-heart-beating donors could greatly increase the pool of cardiac homografts. This hypothesis was investigated in a model of traumatic death with New Zealand rabbits which were exsanguinated after 10 minutes of hypotension.
The hearts were left in situ at normothermia until just before the onset of contracture, were surgically exposed, given either blood cardioplegic, crystalloid cardioplegic, or University of Wisconsin cardioplegic solution, and then stored for 1 hour at 4 degrees C in the respective solutions. The hearts were reperfused for 20 minutes with a Langendorff apparatus. A balloon was placed in the left ventricle, and peak developed pressure and diastolic pressure-volume relationship data were collected over a range of balloon volumes. Control data was obtained from nonischemic rabbit hearts.
Blood cardioplegic solution preserved peak developed pressure and the slope of diastolic pressure-volume relationship at control levels, whereas crystalloid cardioplegic and University of Wisconsin solutions showed significant deterioration in both of these indexes. The total adenine nucleotide pool was significantly improved with the use of blood cardioplegic solution compared with crystalloid cardioplegic and University of Wisconsin solutions although all groups were significantly depressed compared with control values.
This study indicates that hearts harvested from non-heart-beating donors can have function that is not statistically different from controls if preserved with blood cardioplegic solution and that University of Wisconsin and crystalloid cardioplegic solutions are inadequate for preserving hearts harvested under these unique conditions.
使用来自非心脏跳动供体的心脏可极大地增加心脏同种移植物的来源。在新西兰兔创伤性死亡模型中对这一假说进行了研究，这些兔子在低血压10分钟后放血。
心脏在常温下留在原位，直至挛缩即将开始时，通过手术暴露，给予血液停搏液、晶体停搏液或威斯康星大学停搏液，然后在各自的溶液中于4℃保存1小时。用Langendorff装置使心脏再灌注20分钟。在左心室内放置一个球囊，在一系列球囊容积范围内收集峰值收缩压和舒张压-容积关系数据。对照数据取自非缺血兔心脏。
血液停搏液将峰值收缩压和舒张压-容积关系的斜率维持在对照水平，而晶体停搏液和威斯康星大学停搏液在这两个指标上均显示出显著恶化。与晶体停搏液和威斯康星大学停搏液相比，使用血液停搏液时总腺嘌呤核苷酸池显著改善，尽管与对照值相比所有组均显著降低。
本研究表明，如果用血液停搏液保存，从非心脏跳动供体获取的心脏功能与对照组相比在统计学上无差异，并且威斯康星大学停搏液和晶体停搏液不足以在这些独特条件下保存所获取的心脏。
