J Thorac Cardiovasc Surg 2002;123:582
© 2002 The American Association for Thoracic Surgery
The first experiments to use resuscitated human cadaver hearts as donor organs
Francis Robicsek, MD, PhD
Department of Thoracic and Cardiovascular Surgery
The Carolinas Heart Institute and
The Heineman Medical Research Laboratory
Charlotte, NC 28203
To the Editor:
The issue whether resuscitated cadaveric hearts may be used as donor organs has been discussed by several authors during the past decades, and the feasibility of such a task was recently reexamined by several investigators in animal experiments.
I would like to call to the attention of the reader that this subject, that is, whether the resuscitated cadaveric human heart may indeed regain enough appropriate function to serve as a donor organ, has already been demonstrated in 1967. At that time, my colleagues and I
1,2 presented our observations, in which hearts and lungs were removed en bloc from human cadavers within 60 minutes after death, cannulated, placed on cardiopulmonary bypass, resuscitated, then converted into stabilized, autoperfusing heart-lung preparations 3 and allowed to function unassisted. 1 Of the 4 human hearts so handled, 3 worked satisfactorily after resuscitation and maintained normal systemic and pulmonary arterial pressures, pulmonary gas exchange, and cardiac output.
Although our experiments had the shortcomings of technology from 30 years ago, they definitely proved that human hearts and lungs can be harvested from clinically dead donors, resuscitated, and kept functional unassisted outside the body to be used later as suitable grafts for heart-lung transplantation. In our later experiments performed in 1967, we 4 also applied the same technique of resuscitation and preservation to perform orthotopic heart and heart-lung transplantation in the canine model. We used such heart-lung blocks, removed after clinical death, converted into stabilized autoperfusing preparations, maintained outside the body on their own, and then, hours later, inserted into the recipient in the orthotopic position without the use of the heart-lung machine simply by maintaining autoperfusion throughout the transplantation process. The organs so transplanted functioned satisfactorily for several days. These early observations definitely proved that "resuscitated" cadaver hearts may indeed be a significant source of donor organs.
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Fig. 1. The autoperfusing heart-lung preparation. RA, Right atrium; RV, right ventricle; LV, left ventricle. (From Tam W, Robicsek F, Daugherty HK. The autoperfusing heart-lung preparation: a vehicle for the preservation of the resuscitated cadaver heart. J Thorac Cardiovasc Surg. 1969;58: 879-885.)
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12/8/121504doi:10.1067/mtc.2002.121504
References
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Robicsek F, Tam W, Daugherty HK, Robicsek LK. The stabilized autoperfusing heart-lung preparation as a vehicle for extracorporeal preservation. Transplant Proc. 1969;1:834839.
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Tam W, Robicsek F, Daugherty HK. The autoperfusing heart-lung preparation: a vehicle for the preservation of the resuscitated cadaver heart. J Thorac Cardiovasc Surg. 1969;58:879-885.[Medline]
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Robicsek F, Stam RE, Rees TT, Taylor FH, Sanger PW. Transplantation of the heart. II. Hemodynamic observations on the isolated heart. Collected Works Cardio-Pulmonary Dis. 1959;1-2:96-101.
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Robicsek F, Lesage A, Sanger PW, Daugherty HK, Gallucci V. Transplantation of "live" hearts. Am J Cardiol. 1967;20:803-811.[Medline]
