Abstract
<h2>Abstract</h2> <b>Background:</b> Neonatal hearts have altered adhesion molecule interactions in response to ischemia-reperfusion. How this affects myocardial function is unknown. <b>Methods:</b> Isolated, buffer perfused 0- to 2-day (newborn) and 2-week piglet hearts were first subjected to 20-minute global, normothermic ischemia, followed by 45 minutes of reperfusion during which 150 × 10<sup>6</sup> newborn or 2-week neutrophils were infused. In some hearts, an antibody to SLe<sup>x</sup> (CSLEX-1) was infused with neutrophils during reperfusion. Hemodynamic variables, including left ventricular developed pressure (LVDP), were recorded at timed intervals. Neutrophil CD-18, L-selectin, and SLe<sup>x</sup> contents were measured by flow cytometry. <b>Results:</b> Full recovery of LVDP was observed in newborn hearts receiving newborn or 2-week-old neutrophils. Recovery of LVDP was depressed (<i>p</i> < 0.01, ANOVA) in 2-week-old hearts receiving 2-week old, not newborn, neutrophils. Infusion of CSLEX-1 in 2-week-old hearts restored LVDP to baseline. Whereas flow cytometry showed higher (<i>p</i> < 0.01, Student's <i>t</i> test) CD-18 and L-selectin expression on newborn versus 2-week-old neutrophils, newborn neutrophils expressed lower (<i>p</i> < 0.01) SLe<sup>x</sup> levels. <b>Conclusions:</b> Initial "loose" neutrophil-endothelial selectin interactions are a necessary prelude to "firm" adhesion and reperfusion injury. Operations performed soon after birth may be better tolerated than when surgery is delayed; anti-SLe<sup>x</sup> preparations may prove beneficial when performing cardiac procedures on older infants. (Surgery 1998;123:294-304)
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