POSTTRANSPLANTATION FUNCTION OF HEARTS PRESERVED WITH FLUOROCHEMICAL EMULSION

This study was designed to determine whether the novel perfluoroperhyd rophenanthrene-egg yolk phospholipid emulsion, APE-LM, was an effectiv e oxygen carrier for long-term hypothermic heart preservation. We post ulated that hearts preserved with APE-LM would be well oxygenated duri ng 24-hour preservation and that reperfusion of such hearts with blood would not produce functional or metabolic evidence of myocardial isch emia. Four groups of rabbit hearts were studied (n = 7 per group): fre sh controls: nonpreserved, nontransplanted hearts; surgical controls: fresh hearts transplanted heterotopically for 75 minutes before explan t and study for 4 hours as isolated working hearts perfused at 37-degr ees-C; crystalloid-preserved: hearts preserved with crystalloid medium , followed by transplantation and isolated heart perfusion; APE-LM-pre served: hearts treated as those in the crystalloid-preserved group, bu t preservation was with medium containing APE-LM emulsion (10 ml/dl). Preservation was with continuous coronary perfusion at 18 mm Hg pressu re, 12-degrees-C, and oxygen tension 838 +/- 11 mm Hg. During preserva tion, APE-LM hearts had significantly higher pyruvate consumption, and correspondingly higher oxygen consumption, than that of crystalloid h earts. No significant differences were found among fresh controls, sur gical controls, and APE-LM-preserved hearts with respect to contractil e or output function, oxygen consumption and efficiency indexes, or la ctate production during in vitro perfusion. Left ventricular peak syst olic pressure and peak rate of pressure development were significantly lower for crystalloid-preserved hearts than for fresh and surgical co ntrols. Left ventricular end-diastolic pressure of crystalloid-preserv ed hearts was higher than that of the other three groups. The data ind icate that rabbit hearts in this model were well preserved with APE-LM and that this emulsion produced better recovery of function than did crystalloid preservation, possibly as a consequence of the high oxygen delivery by the fluorocarbon during preservation.