Fresh platelet-rich plasma from a flow-through centrifuge for lamb heart perfusion at 13degrees C. Protective effect of added erythrocytes.

Isolated lamb hearts perfused at 13degrees C. with acellular perfusates developed progressive intersitital edema and a rise in vascular resistance. They did not exhbit any electrical or mechanical activity. In contrast, hearts perfused with whole fresh blood remained well preserved, had no edema or change in vascular resistance, and contracted vigorously while being perfused at 10degrees and 13degrees C. This study was designed to determine which particular component(s) of whole blood contributed to improved cardiac preservation. Isolated lamb hearts were perfused for 18 hours at 13degrees C. with plasma containing platelets and some or no red blood cells. Continuously fresh plasma was obtained from a donor animal by means of a flow-through centrifuge. Hearts perfused at 13degrees C. with fresh plasma of either low or high platelet count contracted during the initial 2 to 4 hours of the perfusion only and were as poorly preserved as hearts perfused with acellular microfiltered plasma. A hematocrit value of 2 to 5 per cent in the plasma perfusate resulted in the hearts being preserved almost as well as with fresh whole blood; they showed a forceful cardiac activity at 13degrees C., there was no edema, the vascular resistance was stable, and after rewarming they had good ventricular function. The improvement in cardiac preservation brought about by addition of a minimal amount of red blood cells suggests a specific effect of erythrocytes on the cardiac microcirculation.