Long-Distance Transportation of Canine Hearts for Transplantation: The First Experience in Japan

Abstract

Long-distance procurement of canine hearts following preservation by coro nary perfusion was twice attempted by simple cooling under septic conditions. Following cardiac arrest by cardioplegia, the donor heart was excised and switched to a Langendorff's model. Continuous hypothermic, low-pressure cor onary perfusion with a 4 ° C new modified Krebs solution was performed for seventeen hours. Thereafter, the graft was placed in a thermal (4°C) protected environment. In transportation of 2,124 km, automobiles and commercial air lines were used. The total transport and ischemic times were nine and twenty- seven hours, respectively. The myocardial temperature during both the preservation with coronary perfusion and the transportation by immersion was maintained at 5-7°C. After orthotopic transplantation, both grafts provided good support of the recipient circulation for six-hour and seven-hour observa tion periods. No contraction band injury was histologically observed in the myocardial cells, and the electron microscopic study also revealed almost nor mal features of the myocardial cells after transplantation. The present experi ence suggests that long-distance human heart procurement for transplantation may be safely performed using the conventionally available transportation sys tem in Japan and that the donor heart can be viably stored for a long time (twenty-six hours) by the combination method of coronary perfusion and simple cooling.