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Ann Thorac Surg 1994;58:1651-1656
© 1994 The Society of Thoracic Surgeons

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Articles

Study of efficacies of leukocyte-depleted terminal blood cardioplegia in 24-hour preserved hearts

First Department of Surgery, Osaka University Medical School, Osaka, Japan

Accepted for publication May 9, 1994.

^_* Address reprint requests to Dr Fukushima, First Department of Surgery, Osaka University Medical School, 2-2 Yamada-Oka, Suita, Osaka 565, Japan.

To evaluate the effect of leukocyte-depleted terminal blood cardioplegia on prolonged preservation, 41 canine hearts were stored in modified Collins' solution and transplanted heterotopically. Hearts were transplanted soon after harvesting in group 1 and after 24-hour preservation in groups 2, 3, and 4. Blood cardioplegia was applied just before aortic unclamping in groups 3 and 4; group 3 received simple blood cardioplegia and group 4 received leukocyte-depleted cardioplegia. The percentage of the preload recruitable stroke work and diastolic compliance after transplantation compared with the preharvesting value in group 4 did not differ from those in group 1, but the percentage of the preload recruitable stroke work in groups 2 and 3 was significantly lower than that in groups 1 and 4. The percentage of diastolic compliance in groups 2 and 3 was significantly higher than that in groups 1 and 4. Coronary blood flow 40 minutes after aortic unclamping in group 4 did not differ from that in group 1, but was significantly higher than the blood flows in groups 2 and 3. Significant production of malondialdehyde was detected during terminal blood cardioplegia and 10 minutes after aortic unclamping in groups 2 and 3, but never in groups 1 and 4. After leukocyte-depleted terminal cardioplegia, the myocardial adenosine triphosphate content increased to the preharvesting value in group 4. Our results suggest that leukocyte-depleted terminal blood cardioplegia may be effective in replenishing the energy-depleted myocardium and reducing reperfusion injury, resulting in adequate cardiac function.

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