| Autor: |
Pya Yu.V., Kaliyev, R.B., Bekbossynov, S.T., Lesbekov, T.D., Nurmykhametova Zhuldyz А., Smagulov, N.K., Novikova, S.P., Ashyrov Zh.Z., Faizov, L.R., Medressova, A.T., Murzagaliyev, M.O. |
| Rok vydání: |
2017 |
| Předmět: |
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| DOI: |
10.24411/2308-1198-2017-00045 |
| Popis: |
Background. In 2012, we initiated the first heart transplant programme in Kazakhstan. Donor hearts are transported from distant regions (>1000 km) to be transplanted at our Center. The ob jective of this study was to assess the feasibility of blood cardioplegia as an alternative method to Custodiol for heart preservation. Methods. We performed a retrospective analysis of prospectively collected data. Between May 2014 and February 2016, 20 patients with heart failure underwent heart transplantation using the Organ Care System. Of these, we arrested the donor hearts before explant and before implant using blood cardioplegia and conditioning (ultrafiltration, levosimendan) in ten patients and with standard Custodiol in ten other patients. Results. Preoperative risk factors were comparable in both groups. All patients were alive on the 30th day post implant in both groups. Results were similar for the blood cardioplegia compared to the Custodiol groups for: mean total warm ischemic time was 84.2±28 vs 86.9±8.4 min (p=0.001). Mean ex vivo perfusion time was 266.5±86.7 vs 260.4±88.4 min (p=0.87). Mean venous lactate at the start of perfusion 2.2±0.7 vs 3.4±0.8 mmol/l and at the end of perfusion 5.0±1.9 vs 9.2± 2.1 mmol/l (p=0.001). Seven-day tissue myocardial Doppler results were normal in both groups, except for one patient in the Custodiol group who had right ventricular dysfunction. There were no statistically significant differences in ICU stay between the two groups. Mean ECMO duration was 29.5±28.4 vs 78.4±89 hours (p=0.002). Conclusion. Our observations show that blood cardioplegia and conditioning could be an alternative method for myocardial protection in distant procurement and preservation of donor hearts in the Organ Care System. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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