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The Annals of Thoracic Surgery, Vol 50, 211-214, Copyright © 1990 by The Society of Thoracic Surgeons
R Pillai, K Bando, S Schueler, M Zebly, BA Reitz and WA Baumgartner
Extended preservation of the heart-lung block for 12 hours in a bovine
model of heart-lung transplantation was achieved using donor core cooling,
static hypothermic storage, and reperfusion on cardiopulmonary bypass with
leukocyte-depleted (LD) blood. Orthotopic heart-lung transplantation was
performed with (n = 4, LD group) or without (n = 4, control group) LD blood
during cardiopulmonary bypass. Postoperative measurements of
cardiopulmonary function were made at 2, 4, and 6 hours after reperfusion.
Only 2 animals (50%) of the control group survived more than 2 hours,
whereas all animals in the LD group survived the study period. Arterial
oxygen tension on 100% oxygen was 535.63 +/- 64.96 mm Hg and 146.45 +/-
90.9 mm Hg in the LD and control groups, respectively, at 2 hours (p less
than 0.5) and 524.3 +/- 73.32 and 147.9 +/- 255.67 mm Hg at 6 hours.
Pulmonary artery systolic pressure- to-systemic pressure ratio was 0.49 +/-
0.08 and 0.62 +/- 0.35 at 2 and 6 hours in the LD group. Extravascular lung
water was 17.81 +/- 0.02 mL/kg (control group) and 11.28 +/- 9.15 mL/kg (LD
group) at 2 hours. At reperfusion, the mean neutrophil count was 27 +/- 27
and 764 +/- 635 x 10(9)/L in the LD and control groups, respectively. This
novel approach of leukocyte depletion during reperfusion after heart-lung
preservation resulted in excellent cardiac and pulmonary protection.
ARTICLES
Leukocyte depletion results in excellent heart-lung function after 12 hours of storage
Johns Hopkins Hospital, Baltimore, Maryland.
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