Effects of terminal cardioplegia with leukocyte-depleted blood on heart grafts preserved for 24 hours.

Overview

abstract

Canine hearts immersed in modified Collins solution were transplanted heterotopically (n = 23) and orthotopically (n = 15) to evaluate the effect of terminal warm-blood cardioplegia with or without leukocyte depletion. As the index for graft function, preload recruitable stroke work was measured in both series before harvesting (control) and after transplantation (percentage). The heterotopic hearts were divided into four groups (group 1 to 4) according to the preservation method; hearts were preserved for 3 hours in group 1 and for 24 hours in groups 2, 3, and 4. Simple terminal warm-blood cardioplegia was applied in group 3, and terminal warm-blood cardioplegia with leukocyte depletion was used in group 4. In the orthotopic series, five hearts were transplanted soon after harvesting (group 5) to simulate on-site transplantation, and the remaining ten hearts were transplanted after 24 hours of hypothermic preservation without and with terminal warm-blood cardioplegia with leukocyte depletion (groups 6 and 7, respectively). Among the heterotopic transplants, the percentage of preload recruitable stroke work was highest in group 4 (91% +/- 6%, 51% +/- 4%, 83% +/- 10%, 140% +/- 11% in groups 1, 2, 3 and 4, respectively). All orthotopic transplants in groups 5 and 7 were weaned from cardiopulmonary bypass without inotropic support and without significant differences in cardiac function between groups 5 and 7 (percentage of preload recruitable stroke work, 99% +/- 10% versus 102% +/- 2%; cardiac output, 122 +/- 10 versus 140 +/- 22 ml/kg/min). No orthotopic transplants in group 6 could be weaned from cardiopulmonary bypass, even with inotropic support.(ABSTRACT TRUNCATED AT 250 WORDS)