Collins’ solution for cold storage of the heart for transplantation must be reversed with cardioplegic solution before reperfusion
| Autor: | Kohji Matsuzaki, Atsuo Mitani, Hisataka Yasui, Hisanori Mayumi, Yoshihiro Toshima, Hiroyuki Kohno, Kouichi Tokunaga |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Pulmonary and Respiratory Medicine
Heart transplantation Cardiac output business.industry medicine.medical_treatment Cold storage Rat heart Transplantation Coronary circulation medicine.anatomical_structure Anesthesia medicine Metabolic study Surgery medicine.symptom Cardiology and Cardiovascular Medicine business Vasoconstriction |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 104:1572-1581 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(19)33886-3 |
| Popis: | The following hypotheses were tested using an isolated perfused working rat heart model: (1) Collins' solution for cold storage of the heart is harmful for the heart during reperfusion; (2) a "reverse" of the intracellular-type Collins' solution with an extracellular-type cardioplegic solution before reperfusion is able to prevent this disadvantage of Collins' solution. The following two major groups (I and II) and five subgroups (-a to -e) in each group were prepared. In group I (reversed group); the hearts were initially stored in Collins' solution but were reversed by a 1-minute flush with cardioplegic solution followed by storage in cardioplegic solution for the last 1 to 180 minutes of the total 3-hour storage, that is, groups I-a (reversed for 1 minute), I-b (10 minutes), I-c (30 minutes), I-d (90 minutes), and I-e (180 minutes). In group II (nonreversed control group); the hearts were stored in Collins' solution throughout 3 hours and were also divided into five subgroups of groups II-a, II-b, II-c, II-d, and II-e in which only a 1-minute flush with Collins' solution was performed at the point corresponding to group I. The coronary flow in any of group II showed a marked decrease during the early reperfusion period. In group I, however, the coronary flow increased significantly in proportion to the duration of the reversing phase. The recovery of the aortic flow and the cardiac output in group I showed a bell-shaped pattern in relation to the duration of the reversing phase, reaching their peak values when reversed for 30 minutes (group I-c). The prolonged reverse (180 minutes) resulted in a deterioration of functional recovery associated with a poorer preservation of high-energy phosphates and a larger enzyme leakage. These results suggest that the beneficial effects of intracellular-type Collins' solution for cold storage of the heart were further improved by reversing Collins' solution with the extracellular-type cardioplegic solution for the last 30 minutes of the 3-hour cold storage because the disadvantageous vasoconstriction due to Collins' solution during reperfusion was successfully prevented by the replacement of intravascular and extravascular Collins' solution with cardioplegic solution before the reperfusion. |
| Databáze: | OpenAIRE |
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