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INNOVATIVE METHODOLOGY

Ten-hour preservation of guinea pig isolated hearts perfused at low flow with air-saturated Lifor solution at 26°C: comparison to ViaSpan solution

Anesthesiology Research Laboratory, Departments of ¹Anesthesiology and ²Physiology, ³Cardiovascular Research Center, Medical College of Wisconsin, Milwaukee; ⁴Department of Biomedical Engineering, Marquette University, Milwaukee; and ⁵Research Service, Veterans Affairs Medical Center, Milwaukee, Wisconsin

Submitted 6 February 2007 ; accepted in final form 9 April 2007

There is no suitable solution to preserve hearts for longer than 5 h between donor explant and recipient implant. Lifor is a fully artificial preservation medium containing both a nonprotein oxygen and nutrient carrier (nanoparticles) and cellular nutrients, including amino acids and sugars. We proposed that recirculated Lifor solution would satisfactorily preserve guinea pig isolated hearts perfused at low flow with no added O₂ at room temperature for 10 h. Hearts were isolated from 21 guinea pigs and perfused with Krebs-Ringer (KR) solution (97% O₂ and 3% CO₂) at 37°C. Heart rate, inflow and outflow O₂ tension, coronary flow, left ventricular pressure (LVP), and maximal and minimal rate of change in LVP (dLVP/dt) were measured. After baseline measurements, hearts were perfused with recirculated Lifor or ViaSpan equilibrated with room air at 15% of control flow at 26°C for 10 h. Hearts were then perfused at 100% flow with KR for 2 h at 37°C. A time control (untreated) group was perfused only with KR solution for 15 h. Lifor arrested and protected hearts against diastolic contracture and maintained a low O₂ extraction. Compared with time controls, Lifor led to a higher developed LVP and coronary flow; %O₂ extraction and cardiac efficiency were similar between these two groups. Hearts similarly treated with ViaSpan exhibited diastolic contracture and lower %O₂ extraction during treatment and, upon reperfusion with KR, exhibited continued diastolic contracture, no return of heart rate or contractility, low coronary flow, low %O₂ extraction, and marked infarction. For long-term cardiac protection, a suitable preservation solution recirculated at low flow and room temperature without supplemental O₂ would reduce the support apparatus required for transport. Lifor was far superior to ViaSpan in meeting these requirements.

heart preservation; ischemia-reperfusion injury; nanoparticles