CONCENTRATIONS OF CATECHOLAMINES IN TRANSPLANTED HEARTS AFTER EXTRACORPOREAL PERFUSION AND COLD-STORAGE

Using different perfusion regimes and orthograde implantation, some in vestigators have found sufficient heart function after extracorporeal perfusion of hearts for 24 and even 72 h. However, we found no signifi cant improvement of perfused hearts compared to cold stored hearts aft er a 9-h extracorporeal period. A possible explanation for this findin g could be the excessive liberation of catecholamines during ischemia, as has been demonstrated in isolated perfused hearts. Therefore, the aim of this study was to investigate whether concentrations of noradre naline and dihydroxyphenylglycol (DOPEG) - a noradrenaline metabolite - increased pathologically during continuous extracorporeal heart perf usion for 5 h in pigs, in comparison to hearts stored at 4 degrees C. The venoarterial differences in noradrenaline and DOPEG were not signi ficantly different in the two groups. Concentrations of lactate and py ruvate decreased substantially after 3-h hypothermic perfusion. The la ctate/pyruvate ratio remained at a value of 25-35. Only after the end of the extracorporeal circulation did this ratio reach a value of 40-6 5. In our model, these findings demonstrate that the excessive liberat ion of catecholamines is not a reason for heart failure after cold sto rage or perfusion.