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Ann Thorac Surg 1989;47:860-867
© 1989 The Society of Thoracic Surgeons

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Articles

Eighteen to 37 hours' preservation of major organs using a new autoperfusion multiorgan preparation

Division of Cardiothoracic Surgery, Department of Physiology and Biophysics, and Department of Pathology, University of Kentucky Medical Center, Lexington, Kentucky USA

Accepted for publication December 18, 1988.

^_* Address reprint requests to Dr Chien, Division of Cardiothoracic Surgery, UK Medical Center, Lexington, KY 40536.

A new autoperfusion preparation was used to preserve six major organs simultaneously. In 7 Yorkshire white swine, the heart and lungs were separated and removed with the liver, pancreas, duodenum, and both kidneys en bloc while they were self-perfused. Fresh blood, glucose, electrolytes, heparin sodium, methylprednisolone, and a fat emulsion (Soyacal) were infused through the portal vein. No inotropic drugs were necessary. The organs survived for 18 to 37 hours (average survival, 24.6 ± 2.7 hours [± standard error of the mean]). Aortic systolic pressure ranged from 78.5 ± 5.5 to 98.7 ± 11.8 mm Hg. Arterial oxygen tension ranged from 206 ± 23 to 266 ± 15 mm Hg and arterial carbon dioxide tension, from 20.1 ± 2.7 to 32.1 ± 4.9 mm Hg. Blood lactic acid levels decreased from 8.75 ± 2.06 to 5.50 ± 2.45 mmol/L at 24 hours. Urine output ranged from 25 to 82 mL/h. Blood urea nitrogen levels decreased from 9.17 ± 0.59 to 4.67 ± 1.08 mg/dL. Blood creatinine levels decreased from 1.34 ± 0.10 to 0.57 ± 0.22 mg/dL. Serum glutamic-oxaloacetic transaminase levels increased from 73.4 ± 26.3 to 194 ± 179.5 U/L and serum glutamic-pyruvic transaminase levels, from 44.8 ± 5.7 to 91 ± 66.4 U/L. Red blood cell count ranged from 6.94 ± 0.58 to 13.23 ± 2.30 x 10⁶/µL. Lung wet/dry weight ratios changed from 5.79 ± 0.17 at the beginning to 6.25 ± 0.16 at 24 hours. The technique for simultaneous multiorgan preservation presented here is simple, effective, and highly reproducible. This study appears to have produced one of the longest average survival times for autoperfusion.

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