冷浸泡法保存缺血猪心(英文)

Cold Storage of Ischemic Porcine Heart

为探寻供心来源和延长心脏保存时间，本实验采用与人心大小、重量、冠状血管结构及传导系统均相似的成年猪心13个。取心前放血2000～3000ml，经灌注心停搏液后即浸泡于4℃该液体中保存2．50～6．08h（平均4．60±0．36h）。11个心脏用初始稀释血行体外循环心脏复苏并测试心功能，用温血心麻痹液再灌注（5～8min）以减轻再灌注损伤，另2个心脏于保存6h后行超微结构观察。7个心脏自动复跳，4个需电击除颤，测试心排量为2725±246ml／min，其中1个心脏保存6h，心排量达4200ml／min。在保存6h心脏心肌超微结构无不可逆损伤。结论：既使在严重急性失血情况下，采用冷保存法和温血心麻痹液再灌注复苏，可使猪心保存期延长至6h。

In order to explore donor heart resources and try to extend heart preservation time,13 adult porcine hearts which are similar to human heart in size, weight, coronary architecture and conduction system were used in this eoperiment. The donor pigs were bled 2000~3000ml of blood before heart procurement. Hearts were flushed with and stored in a crystalloid cardioplegia solution for 2.50 to 6.08 hours (mean=4.6±0.36h). Eleven of them were then resuscitated and tested for function in vitro by a heart lung machine which was primed with diluted blood. Warm blood cardioplegia solution was used for the initial roperlusion (5~8min) to reduce reperfusion injury. The other 2 hearts after storage for 6h were sent for ultrastructural study. Seven hearts resumed beating spontaneously, and 4 required defibrillation. The cardiac output(CO) was 2725±246ml/min with one heart preserved for 6h reaching 4200 ml/min. There was no irreversible damage in the myocardial ultrastructure in hearts preserved for 6 hours. In conclusion, porcine hearts could be preserved for up to 6 h with cold storage and resuscitated by the warm blood cardioplegia reperfusion method even the donors had severe bleeding.