MYOCARDIAL PRESERVATION USING HTK SOLUTION FOR HEART-TRANSPLANTATION - A MULTICENTER STUDY

Bretschneider HTK solution is commonly used for myocardial preservatio n. In order to evaluate its protective effect for heart transplantatio n, a retrospective study was initiated in cooperation with Eurotranspl ant and five heart transplant centers. Seventy-six female and 524 male patients who underwent cardiac transplantations between 1981 and 1991 were included in this study. Using standardized questionnaires, donor and recipient laboratory data, immunosuppressive therapy and the preo perative, intraoperative and postoperative organ function were documen ted. The average ischemic time of the donor hearts was 160 min, rangin g from 75 min-304 min. Immediate postoperative graft failure was obser ved in 25 transplantations (4.2%). Within the first 30 days 71 organs (11.8%) failed. Using the chi2-test, a statistically significant incre ase of acute graft failure and early mortality was evident when they w ere correlated with the length of ischemic time (P = 0.01). In additio n, a higher incidence of early graft failure was observed when the per fusion volume was less than 1500 ml. The 1- and 5-year survival rates were 72% and 63%, respectively. Organ preservation with HTK shows good results as long as the ischemic time does not exceed 4 h. The possibi lity that an increased perfusion volume allows longer ischemic times c annot be excluded with this study.