| Background and Objective In modern society, the incidence of heart failure increases year by year. End-stage heart failure will lower the quality of life of patients, and reduce the survival time. Heart transplant is recognized as the preferred therapy to treat with end-stage heart failure. With the development of immunity inhibitor and surgical technology, heart transplant has turned from experimental technique to conventional surgical treatment. It has been performed extensively in clinic, and benefits more and more patients. As well as other types of organ transplants, heart transplant is constrained by various factors: Firstly, the lack of donors, there are few patients who will volunteer their organs after cerebral death for the influence of traditional concepts; secondly, the costly expense of transplant surgery and immune inhibitors for life; thirdly, it’s difficult to make full use of organs, in dormestic, there’s no national organized organ donation and distribution internet established. Just for the preciousness of heart, we should treat with each case of donor heart prudently, to protect the functional state as much as possible, so the patients can benefit more. The research aims at explore the protective role of terminal warm cardioplegia perfusion method in the donor heart in heart transplant.Materials and Methods 12 pairs of Swedish pig of sucessfully matching of the same family, divided into 2 groups at random, namely test group and control group, 6 pairs in each group. Performed orthotopic heart transplantation in each group. Release aorta clamps normally to restore cardiac perfusion after operation in the control group. While in the test group, aorta clamps would be released after a transient final perfusion. The blood samples were taken from orifice of coronary sinus and aortic root before the ischemia of donor heart, at 5min,30 min,1h,2h after restoration of cardiac perfusion, take blood-gas analysis to compare the content of lactic acid, partial oxygen pressure and detect the blood flow of orifice of coronary sinus; collect the blood samples from internal carotid artery of pigs who receive donor heart at the time of restoration of perfusion,4h,12 h,24h after restoration of perfusion,to detect the density of c Tn T.Results There is no significant difference of the coronary blood flow after the restoration of cardiac perfusion in test group and control group(Fgroup=2.193,P=0.173>0.05)。The oxygen utilization ratio of heart after operation, lactate utilization and the density of c Tn T at diffrent time between control group and test group, were all contracted obviously, with significant difference(Fgroup=9.041、Ftime=44.844 ' 138.908,P<0.05). The oxygen utilization ratio of test group rescovered earlier; the lactate utilization of myocardium in test group was higher than that in control group at 5min after restoration of perfusion; and the density of c Tn T in test group is lower than that in control group at 1 h after restoration of perfusion(P<0.05).Conclusion Terminal warm cardioplegia perfusion in heart transplant can lower the level of anaerobic metabolism of myocardium, promote the rescovery of cardiocyte and reduce the damage of cardiocyte. |
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