目的 通过自行设计的离体心脏灌注装置,建立连续灌注大型动物心脏保存模型;评价连续灌注对供心保存的效果.方法 广西巴马小型猪24头,分别作为供、受体.单纯冷保存组(n=6):供心在4℃的UW液中冷保存8 h后移植到受体猪;连续灌注组(n=6):心脏停搏后连接灌注装置,连续灌注氧合血停搏液,体外保存供心8 h后移植到受体猪.观察两组移植心脏恢复情况,进行左室功能监测,包括左室收缩压(LVSP),左室舒张末压(LVEDP),左室内压最大上升/下降速率(±dP/dtmax),并测定心肌组织氧摄取分数和心肌含水量.结果 主动脉开放后3 min内心脏自动复跳率连续灌注组优于冷保存组(P=0.015);尽管连续灌注组心肌含水量在实验结束时高于冷保存组,但心肌功能测定不论是收缩功能的指标(LVSP、+dP/dtmax),还是舒张功能的指标(LVEDP、-dP/dtmax),连续灌注组均优于冷保存组(P<0.0001).结论 本自行设计的实验装置,可成功建立连续灌注保存大型动物(猪)心脏模型,与常规冷保存相比,减少缺血性损害,心脏自动复跳率高,功能恢复良好,能够延长供心保存时限.%Objective To evaluate the preservative effect for donor hearts by establishing the continuous persusion ( CP ) preservation model of large animal. Methods Twenty —four Bania miniature pigs were used as donors and recipients. Hearts were arrested with cardioplegic solution, then were either stored in cold UW solution for 8 hours at 0 — 4℃ ( CS group, n =6 ) or continuously perfused with oxygenated blood cardioplegia for 8 hours ( CP group, n = 6 ). After preservation, hearts were transplanted into recipients and re perfused for 3 hours. Left ventricular ( LV ) function and water content were measured. Results Most of CP hearts automatically reverted to normal sinus rhythm, whereas all hearts in CS group required DC shock and one of the hearts could not be successfully reverted. Although water content of CP hearts was higher than that of CS, LV contractility and diastolic function of CP hearts were superior to those of CS. Conclusion We have succeeded in establishing continuous perfusion preservation model of donor hearts with oxygenated blood cardioplegia. Donor hearts could be preserved longer using continuous perfusion and CP hearts performed better function than that of CS hearts.
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