CONTINUOUS WARM REPERFUSION DURING HEART-TRANSPLANTATION

From April 1991 to January 1993, 37 orthotopic heart transplantations were performed at our institution, Conventional preservation technique with cold crystalloid cardioplegia and topical hypothermia during sto rage and implantation was used in the first 15 cases (group A), After January 1992, for the next 22 patients (group B), we administered a fi rst dose of hyperkalemic blood cardioplegia on arrival of the graft an d thereafter instituted continuous warm reperfusion by infusion of oxy genated blood with added potassium. The groups were compared retrospec tively, and significant differences were observed, In group B, the Isc hemic time was shortened by 31 minutes, the suture time lasted 12 minu tes longer, sinus rhythm recovered spontaneously, the duration of inot ropic support was reduced, postoperative arrythmias decreased, length of intensive care and hospital stays were reduced, there was less isch emic damage in the first endomyocardial biopsy sample, and right ventr icular pressures a month after operation were lower, Continuous warm r eperfusion during implantation of the donor heart is technically feasi ble and seems to provide enhanced myocardial preservation.