Management of donor heart protection in orthotopic heart transplantation (a re-port of 133 cases)

Zhao Yang; Dong Nian-guo; Liu Jin-ping; Li Ping

doi:10.13498/j.cnki.chin.j.ecc.2014.04.07

Abstract：[ Abstract]:Objective To summarize the management experiences of donor heart protection in 133 orthotopic heart transplanta?tion patients. Methods From Sep. 2008 to May 2014, 133 patients with end-stage heart disease underwent orthotopic heart transplan?tation in Wuhan Union hospital. Among them, 103 cases received non-arrest donor heart ( groupⅠ) and 30 cases received arrest do?nor heart ( groupⅡ) . In Group I, 4℃ ST. Thomas solution was infused through aortic roots after aorta was cross clamped to make donor hearts arrested quickly first, then the donor hearts were soaked and preserved and transported in 8℃ HTK solution;In groupⅡ, 8℃HTK solution was infused through aortic roots after aorta was cross clamped, and the donor hearts were preserved in HTK solution. Re?sults In group I, 92 patients recovered heart beating automatically after clamp removed, and 11 patients recovered heart beating by e?lectric defibrillation. The donor heart warm ischemic period was (3.25±2.25) min and cold ischemic period was (253.22±136.73) min. Postoperative utilization rate of IABP was 9.5%, EF values of three weeks after heart transplantation was (65.52 ± 6.72)%, one year survival rate was 92.55%. In group II, 23 cases recovered heart beating automatically after clamp removed and 7 patients recovered heart beating by electric defibrillation. The donor heart warm ischemic period was ( 5. 78 ± 2. 82) min and cold ischemic period was (179.12±52.43) min. Postoperative utilization rate of IABP was 10.1%, EF values of three weeks after heart transplantation was (65.78±7.22), one year survival rate was 91.07%. Conclusion Using different donor heart procurement and efficient heart preserva?tion during perioperative period are considerably important for a successful heart transplantion, it expand the use of edging donor hearts and improve the success rate of heart transplantation.