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The Journal of Thoracic and Cardiovascular Surgery, Vol 102, 224-234, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
S Chien, PR Oeltgen, JN Diana, X Shi, SP Nilekani and R Salley
A new autoperfusion multiorgan preparation was studied in which the heart
and lungs were removed with the liver, pancreas, duodenum, and both kidneys
en bloc while being perfused by the heart and oxygenated by the lungs. A
respirator with 50% oxygen was used for ventilation. Fresh blood, glucose,
electrolytes, mannitol, and antibiotics were given through the portal vein.
Fifteen mongrel dogs were used. In the study group (seven dogs), 10 ml of
plasma containing hibernation induction trigger, obtained from deeply
hibernating woodchucks, was given intravenously 2 hours before the
operation, and 4 ml was given every 4 hours during the preservation period.
In the control group (eight dogs), no hibernation induction trigger was
used. Survival time in the study group ranged from 33 to 56 hours (mean
43.4 +/- 4.1 hours), longer than that of the control group, which was 9 to
31 hours (mean 16.2 +/- 2.6 hours, p less than 0.001). In the study group
aortic systolic pressure ranged from 64 +/- 5 to 92 +/- 7 mm Hg, arterial
oxygen tension from 180 +/- 35 to 285 +/- 66 mm Hg. Urine output ranged
from 15 to 70 ml/hour. Blood urea nitrogen declined from 15.6 +/- 2.5 to
6.6 +/- 1.3 mg/dl (p less than 0.01); creatinine declined from 0.8 +/- 0.03
to 0.3 +/- 0.01 mg/dl (p less than 0.01). Severe liver congestion and
premature renal failure occurred in the control group but did not occur in
the study group. In the study group one lung was transplanted after 33
hours of preservation with simultaneous contralateral pulmonary artery
ligation. Good lung function was maintained after transplantation. Although
the exact mechanism by which hibernation induction trigger extends tissue
survival time is still not clear, its effect on organ preservation is
profound. This study also produced one of the longest average survival
times for organ preservation.
ARTICLES
Two-day preservation of major organs with autoperfusion multiorgan preparation and hibernation induction trigger. A preliminary report
Department of Surgery, University of Kentucky Medical Center, Lexington 40536.
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