Heart preservation with metabolic inhibitor, hypothermia, and hyperbaric oxygenation. 1974

K Todo, and S Nakae, and J Wada

The effect of metabolic inhibitor, hypothermia (4 degrees C) and hyperbaric oxygenation (3 atm) on prolonging survival of the canine anoxic heart has been evaluated. Donor hearts were obtained from small mongrel dogs by giving the pre-cooled perfusate of 2 per cent magnesium sulfate (MgSO4), 5 per cent low molecular weight dextran (LMWD) and 2 per cent glucose into the right atrium. Excised hearts were kept at 4 degrees C in a hyperbaric chamber pressurized to 3 atm. After 18 to 48 hours the preserved hearts were transplanted to the neck of recipients by the methods of Marcus. The viability of the preserved hearts were evaluated with functional, biochemical and histologic parameters. Of 29 hearts preserved for 18 to 36 hours, 27 hearts returned to a strong coordinated beat and could maintain function for over 4 hours. Of 5 hearts preserved for 48 hours, 4 showed a coordinated ventricular beat, however, failed to maintain cardiac work over 4 hours. The hearts with 18 to 36 hours storage showed no significant abnormalities on myocardial metabolism and morphology as compared to the control group of the immediately transplanted hearts. The protective action of magnesium is probably related to a number of factors, including metabolic depression and stabilizing effect on membrane permeability of cells to potassium, which would tend to maintain a more normal membrane potential and sub-cellular particles. These studies indicate that viability of the mammalian anoxic hearts can be extended to 36 hours by the combined use of metabolic blockade, hypothermia and hyperbaria suggesting a practical approach to procurement and preservation of cadaver organs.

UI MeSH Term Description Entries
D008278 Magnesium Sulfate A small colorless crystal used as an anticonvulsant, a cathartic, and an electrolyte replenisher in the treatment of pre-eclampsia and eclampsia. It causes direct inhibition of action potentials in myometrial muscle cells. Excitation and contraction are uncoupled, which decreases the frequency and force of contractions. (From AMA Drug Evaluations Annual, 1992, p1083) Magnesium Sulfate, Heptahydrate,Heptahydrate Magnesium Sulfate,Sulfate, Magnesium
D009206 Myocardium The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow. Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D009926 Organ Preservation The process by which organs are kept viable outside of the organism from which they were removed (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). Organ Preservations,Preservation, Organ,Preservations, Organ
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010477 Perfusion Treatment process involving the injection of fluid into an organ or tissue. Perfusions
D011188 Potassium An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
D003080 Cold Temperature An absence of warmth or heat or a temperature notably below an accustomed norm. Cold,Cold Temperatures,Temperature, Cold,Temperatures, Cold
D003326 Coronary Circulation The circulation of blood through the CORONARY VESSELS of the HEART. Circulation, Coronary
D003864 Depression, Chemical The decrease in a measurable parameter of a PHYSIOLOGICAL PROCESS, including cellular, microbial, and plant; immunological, cardiovascular, respiratory, reproductive, urinary, digestive, neural, musculoskeletal, ocular, and skin physiological processes; or METABOLIC PROCESS, including enzymatic and other pharmacological processes, by a drug or other chemical. Chemical Depression,Chemical Depressions,Depressions, Chemical
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog

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