early reperfusion hemodynamics predict recovery in rat hearts a potential approach towards evaluating cardiac grafts from non-heart-beating donors老鼠的心脏复苏早期再灌注血液动力学预测潜在的方法评估心脏移植non-heart-beating捐助者.pdfVIP

Early Reperfusion Hemodynamics Predict Recovery in Rat Hearts: A Potential Approach towards Evaluating Cardiac Grafts from Non-Heart-Beating Donors 1 1,2 1,3 1 ´ 2 Monika Dornbierer , Mathieu Stadelmann , Joevin Sourdon , Brigitta Gahl , Stephane Cook , 1 1 1 Thierry P. Carrel , Hendrik T. Tevaearai *, Sarah L. Longnus 1 Department of Cardiovascular Surgery, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland, 2 Cardiology, University Hospital, Fribourg, Switzerland, 3 University of Auvergne, Institute of Technology, Clermont-Ferrand, France Abstract Aims: Cardiac grafts from non-heartbeating donors (NHBDs) could significantly increase organ availability and reduce waiting-list mortality. Reluctance to exploit hearts from NHBDs arises from obligatory delays in procurement leading to periods of warm ischemia and possible subsequent contractile dysfunction. Means for early prediction of graft suitability prior to transplantation are thus required for development of heart transplantation programs with NHBDs. Methods and Results: Hearts (n = 31) isolated from male Wistar rats were perfused with modified Krebs-Henseleit buffer aerobically for 20 min, followed by global, no-flow ischemia (32uC) for 30, 50, 55 or 60 min. Reperfusion was unloaded for 20 min, and then loaded, in working-mode, for 40 min. Left ventricular (LV) pressure was monitored using a micro-tip pressure catheter introduced via the mitral valve. Several hemodynamic parameters measured during early, unloaded reperfusion correlated significantly with LV work after 60 min reperfusion (p