HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert G. Strange, Jr Ralph J. Damiano, Jr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hoenicke, E. M. Articles by Damiano, R. J. Search for Related Content PubMed PubMed Citation Articles by Hoenicke, E. M. Articles by Damiano, R. J., Jr

J Thorac Cardiovasc Surg 2000;120:746-754
© 2000 The American Association for Thoracic Surgery

Cardiothoracic Transplantation

Donor heart preservation with a novel hyperpolarizing solution: Superior protection compared with University of Wisconsin solution

From the Department of Surgery, Division of Cardiothoracic Surgery, The Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pa.

Supported by National Institutes of Health grants HL-51032 (R.J.D.) and Penn State College of Medicine Department of Surgery Feasibility Grant (E.M.H., R.J.D.).

Address for reprints: Ralph J. Damiano, Jr, MD, Department of Surgery, Division of Cardiac Surgery, Washington University School of Medicine, Campus Box 8234, Suite 3108 Queeny Tower, One Barnes-Jewish Hospital Plaza, St Louis, MO 63110 (E-mail: damianor{at}msnotes.wustl.edu).

Objectives: A donor heart preservation solution was designed to use hyperpolarized arrest with the adenosine triphosphate–sensitive potassium-channel opener pinacidil. This solution contained concentrations of potassium, sodium, calcium, magnesium, lactobionate, and the buffer histidine specifically chosen to minimize intracellular calcium accumulation associated with prolonged ischemia.
Methods: Twenty-four rabbit hearts were randomly assigned to receive 1 of 3 preservation solutions in a crystalloid-perfused Langendorff model: (1) prototype solution containing a 0.5 mmol/L concentration of pinacidil, (2) prototype solution without pinacidil as control, and (3) University of Wisconsin solution. Thirty minutes of initial perfusion preceded baseline data acquisition. Data comprised left ventricle pressure-volume curves generated by inflating an intraventricular latex balloon. After cardioplegic administration, hearts underwent 4 hours of hypothermic storage, followed by 60 minutes of reperfusion and postischemic data acquisition.
Results: Postischemic developed pressure was better preserved by pinacidil solution (92.4% ± 4.5%) than by the control (74.9% ± 3.4%, P = .01) and University of Wisconsin solutions (66.7% ± 5.1%, P = .001). Diastolic negative dP/dT was better preserved by pinacidil solution (104.4% ± 10.2%) than by the control (80.2% ± 4.2%, P = .034) and University of Wisconsin solutions (71.7% ± 7.0%, P = .015). Diastolic compliance, expressed as baseline/postischemic diastolic slope ratios, was more poorly preserved by University of Wisconsin solution (0.67 ± 0.07) than by the pinacidil (0.88 ± 0.05, P = .041) and control solutions (0.87 ± 0.05, P = .021). Postischemic coronary flow was higher in hearts exposed to pinacidil solution (77.8% ± 3.0%) than in those exposed to the control (66.8% ± 2.4%) and University of Wisconsin solutions (70.9% ± 4.0%, P = .07).
Conclusions: The superiority of the pinacidil solution in this experiment demonstrated that hyperpolarized arrest with potassium-channel openers improves donor heart preservation when administered in a novel histidine-buffered lactobionate-enriched vehicle.

This article has been cited by other articles:

				M. D. Diodato, N. R. Shah, S. M. Prasad, S. L. Gaynor, J. S. Lawton, and R. J. Damiano Jr Donor heart preservation with pinacidil: the role of the mitochondrial KATP channel Ann. Thorac. Surg., August 1, 2004; 78(2): 620 - 627. [Abstract] [Full Text] [PDF]

				D. J. Chambers Mechanisms and alternative methods of achieving cardiac arrest Ann. Thorac. Surg., February 1, 2003; 75(2): S661 - 666. [Abstract] [Full Text] [PDF]