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The Journal of Thoracic and Cardiovascular Surgery, Vol 94, 836-842, Copyright © 1987 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

A no-flush, core-cooling technique for successful cardiopulmonary preservation in heart-lung transplantation

GJ Kontos Jr, H Adachi, MA Borkon, DE Cameron, WA Baumgartner, GM Hutchins, J Brawn and BA Reitz
Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD 21205.

In order to determine whether a no-flush, core-cooling technique could provide extended heart-lung preservation, we placed donor calves on cardiopulmonary bypass and instituted rapid cooling to 15 degrees C during the continuous infusion of isoproterenol. The heart and lungs were harvested after the administration of a cardioplegic solution through the aortic root. In the control group (N = 5), heart and lungs were orthotopically allotransplanted immediately. In the preserved group (N = 5), heart and lungs were similarly excised but were stored in a normal saline bath at 4 degrees C for approximately 4 hours and then transplanted. Both groups received isoproterenol during reperfusion and were studied for 6 hours after implantation. A load independent analysis of myocardial function was done by determining with a sonomicrometer the ratio of the end-systolic pressure to the end- systolic dimension. Pulmonary preservation was evaluated by measurement of extravascular lung water with a double-indicator dilution method, arterial oxygenation on 100% inspired oxygen, and serial lung biopsies. Myocardial and pulmonary function after 4 hours of static preservation was found to be similar to controls. No-flush, core-cooling with cardiopulmonary bypass provides adequate cardiorespiratory function after acute bovine heart-lung allotransplantation. With the use of this technique, successful extended cold ischemic cardiopulmonary preservation for heart-lung transplantation may be achieved.

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				J. S. Ganesh, C. A. Rogers, N. R. Banner, R. S. Bonser, and Steering Group of the UK Cardiothoracic Transplant Does the method of lung preservation influence outcome after transplantation? An analysis of 681 consecutive procedures. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1313 - 1321. [Abstract] [Full Text] [PDF]