CAPE-TOWN SOLUTION IN PROLONGED MYOCARDIAL PRESERVATION - STRUCTURAL AND ULTRASTRUCTURAL-STUDY

This study deals with myocardial preservation after 24 hours of contin uous, hypothermic and oxygenated perfusion with Cape Town (CT) solutio n, focusing on the morphological changes produced by preservation and reperfusion, and their possible relationship to the composition of the solution and the immediate hemodynamic findings after orthotopic hear t transplantation in dogs. After preservation, aside from mild or mode rate mitochondrial changes, the most relevant lesions included edema a nd vasoconstriction. Reperfusion was followed by the development of ar eas of necrosis forming contraction bands and an increment in the mito chondrial damage; the intercalated disks conserved their normal struct ure; edema became more prominent and was invariably accompanied by hem orrhage; vasoconstriction was very pronounced and was accompanied on o ccasion by evidence of capillary rupture; and inflammatory cells were observed in the interstitium. These results indicate that colloid must be added to Cape Town solution and that reperfusion probably requires selective approaches to deal with vasoconstriction and inflammation.