ABSTRACT
Since no appropriate system has been established for the transportation of donor hearts in japan, the establishment of successful techniques for their preservation of a longer period is necessary for heart transplantation. The purpose of this study is to assess energy charge as a parameter of the viability in the prolonged heart preservation. Hearts from ten mongrel dogs were excised after being flushed with cold Young's solution and were perfused with LV vent for 24 or 48 hours at 30 cm H2O. The composition of the perfusate was K+40, Mg2+26 mEq/L, and the pH was controlled around 7.5 and the temperature 4-7 degrees C. After Langendorff's perfusion for forty minutes, five hearts were reperfused at 31 degrees C in a circuit using an organic filter, and were evaluated for hemodynamic parameters. Four hearts which were preserved for 48 hours had poor results, however one heart preserved for 24 hours showed very good hemodynamic data equivalent to those from hearts immediately after excision. In metabolic studies from another five cases myocardial energy charge retained the value above 0.8 for 40 hours, although myocardial adenosine triphosphates gradually diminished; however, both decreased rapidly after 40 hours. Considering that the energy charge represents real viability of myocardium, together with the changes in pH, etc., it is suggested that this method can safely preserve the isolated hearts up to 40 hours.
