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Ann Thorac Surg 1988;46:337-341
© 1988 The Society of Thoracic Surgeons

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Articles

Cardiac Transplantation: The Ideal Myocardial Temperature for Graft Transport

From the Department of Cardiothoracic Surgery, University of Ottawa Heart Institute, Ottawa Civic Hospital, and the Department of Physiology, University of Ottawa, Ottawa, Ont, Canada

Accepted for publication March 31, 1988.

^* Address reprint requests to Dr. Keon, University of Ottawa Heart Institute, Ottawa Civic Hospital, 1053 Carling Ave, Ottawa, Ont, Canada, K1Y 4E9.

The ideal preservation method and cooling temperature for transport of donor hearts are not known. Serious derangements in myocardial relaxation are well described with different methods of cooling. To assess this problem, human right atrial trabeculae contracting isometrically at 34°C in vitro were subjected to hypothermic arrest at 1, 4, 12, and 20°C for 1, 2, 4, 24, and 48 hours. Control conditions were resumed, and myocardial mechanical recovery was assessed over 1 hour. Contraction was 50% depressed after a 1- to 2-hour exposure to 1°C and was almost completely arrested following a 4-hour exposure. Muscles cooled to 4°C recovered poorly, whereas those cooled to 12 and 20°C did well. In the latter 2 groups, force development increased rapidly on rewarming and exceeded the precooling contraction force (p < 0.05). A 100% increase in relative resting force was seen in muscles cooled to 1 and 4°C (p < 0.05). This finding suggests a failure of calcium homeostasis at very low temperatures. We conclude that atrial preservation is optimal at about 12°C.

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