Fukushima N, Shirakura R, Nakata S, Kaneko M, Miyagawa S, Naka Y, Chang J C, Matsumiya G, Nakano S, Matsuda H
First Department of Surgery, Osaka University Medical School, Japan.
Ann Thorac Surg. 1994 Dec;58(6):1651-6. doi: 10.1016/0003-4975(94)91652-7.
To evaluate the effect of leukocyte-depleted terminal blood cardioplegia on prolonged preservation, 41 canine hearts were stored in modified Collins' solution and transplanted heterotopically. Hearts were transplanted soon after harvesting in group 1 and after 24-hour preservation in groups 2, 3, and 4. Blood cardioplegia was applied just before aortic unclamping in groups 3 and 4; group 3 received simple blood cardioplegia and group 4 received leukocyte-depleted cardioplegia. The percentage of the preload recruitable stroke work and diastolic compliance after transplantation compared with the preharvesting value in group 4 did not differ from those in group 1, but the percentage of the preload recruitable stroke work in groups 2 and 3 was significantly lower than that in groups 1 and 4. The percentage of diastolic compliance in groups 2 and 3 was significantly higher than that in groups 1 and 4. Coronary blood flow 40 minutes after aortic unclamping in group 4 did not differ from that in group 1, but was significantly higher than the blood flows in groups 2 and 3. Significant production of malondialdehyde was detected during terminal blood cardioplegia and 10 minutes after aortic unclamping in groups 2 and 3, but never in groups 1 and 4. After leukocyte-depleted terminal cardioplegia, the myocardial adenosine triphosphate content increased to the preharvesting value in group 4. Our results suggest that leukocyte-depleted terminal blood cardioplegia may be effective in replenishing the energy-depleted myocardium and reducing reperfusion injury, resulting in adequate cardiac function.
为评估去白细胞终末血液停搏液对延长保存的效果，将41只犬心脏置于改良柯林斯液中并进行异位移植。第1组心脏在收获后立即移植，第2、3、4组心脏在保存24小时后移植。第3、4组在主动脉阻断前应用血液停搏液；第3组接受单纯血液停搏液，第4组接受去白细胞停搏液。与第1组收获前值相比，第4组移植后前负荷可募集搏功和舒张顺应性的百分比与第1组无差异，但第2、3组前负荷可募集搏功的百分比显著低于第1、4组。第2、3组舒张顺应性的百分比显著高于第1、4组。第4组主动脉阻断40分钟后的冠状动脉血流量与第1组无差异，但显著高于第2、3组。在第2、3组的终末血液停搏期间及主动脉阻断后10分钟检测到显著的丙二醛生成，但第1、4组未检测到。在去白细胞终末停搏后，第4组心肌三磷酸腺苷含量增加至收获前值。我们的结果表明，去白细胞终末血液停搏液可能有效地补充能量耗竭的心肌并减少再灌注损伤，从而产生足够的心脏功能。
