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Ann Thorac Surg 1984;37:243-248
© 1984 The Society of Thoracic Surgeons

Articles

Cardiac Transplantation Following Storage of the Donor Heart by a Portable Hypothermic Perfusion System

W.N. Wicomb, B.Sc., D.K.C. Cooper, M.B., B.S., Ph.D.*, D. Novitzky, M.D., C.N. Barnard, M.Med., M.S., Ph.D., D.Sc.(Hon Causa)

From the Department of Cardiac Surgery, Groote Schuur Hospital and University of Cape Town Medical School, Cape Town, Republic of South Africa

Accepted for publication May 10, 1983.

* Address reprint requests to Dr. Cooper, Department of Cardiac Surgery, University of Cape Town Medical School, Cape Town, Republic of South Africa

Four patients have undergone heterotopic heart transplantation with donor hearts stored by a portable hypothermic perfusion system. Total ischemic periods ranged from 6 hours 55 minutes to 16 hours 50 minutes. One heart, transplanted into a patient who had acutely rejected a previous graft, suffered accelerated, irreversible, acute rejection within five days, associated with strong antibody formation; donor heart function was never good. In the 3 remaining patients, donor heart function was good after initially being poor for a few hours in 2 patients. One patient died of long-term rejection after 6 months and 1 of tuberculous meningitis after 10 months; 1 remains alive at 15 months.

Neither preservation of the donor heart for periods in excess of approximately 4 hours nor the use of continuous hypothermic perfusion as a method of preservation appears to have been reported previously in the context of the clinical situation.




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