Concentrations of catecholamines in transplanted hearts after extracorporeal perfusion and cold storage.

Using different perfusion regimes and orthograde implantation, some investigators have found sufficient heart function after extracorporeal perfusion of hearts for 24 and even 72 h. However, we found no significant improvement of perfused hearts compared to cold stored hearts after a 9-h extracorporeal period. A possible explanation for this finding could be the excessive liberation of catecholamines during ischemia, as has been demonstrated in isolated perfused hearts. Therefore, the aim of this study was to investigate whether concentrations of noradrenaline and dihydroxyphenylglycol (DOPEG)--a noradrenaline metabolite-increased pathologically during continuous extracorporeal heart perfusion for 5 h in pigs, in comparison to hearts stored at 4 degrees C. The venoarterial differences in noradrenaline and DOPEG were not significantly different in the two groups. Concentrations of lactate and pyruvate decreased substantially after 3-h hypothermic perfusion. The lactate/pyruvate ratio remained at a value of 25-35. Only after the end of the extracorporeal circulation did this ratio reach a value of 40-65. In our model, these findings demonstrate that the excessive liberation of catecholamines is not a reason for heart failure after cold storage or perfusion.