Abstract

Objective To evaluate the possibility of heart transplantation with non-heart-beating donor (NHBD) graft, and the cardial protective effects of Na+/H+ exchange inhibitor (HOE-642) plus KATP channel opener (Nicorandil) on NHBD. Methods Twenty-four male adult porcine were randomly assigned to two groups: (1) Donor hearts harvested from NHBD in which heart arrest was induced by means of exsanguination (keeping blood pressure at zero for 30 rain, and heart arrest for 9 to 12 min), and donor heart was protected by means of HOE-642/Nicorandil enriched Stanford solution as well as HOE-642/Nicorandil-enriched blood cardioplegia, in addition, HOE-642 was intravenously used before exsanguination and during the initial period of reperfusion (i. e. , after decrossclamping of aorta) (experimental group, n = 6) ; (2) Donor hearts harvested from heart-beating donor (HBD), and protected by clinically used routing method (control group, n = 6). All harvested hearts in both groups underwent a 4 h cold storage, followed by orthotropic heart transplantation. Left ventricular mechanical performance (LVPDP, LVEDP, + dp/dt, -dp/dt), and myocardial water content (MWC) were determined, hearts were also analyzed under the light microscopy or electron microscopy for structural injuries. Results All animals could wean from cardiopulmonary bypass successfully.There were no significant differences between experimental group and control group in left ventricular mechanical performance and MWC (P＞0. 05). There was no serious cell damage when examined under the light and transmission electron microscopy and cardiomyocytes were well preserved in both groups. Conclusion Heart transplantation using NHBD heart could lead to the same encouraging outcome as using HBD heart, and this kind of donor hearts might be an ahernative potential resource of graft for heart transplantation. HOE-642 plus nicorandil is feasible to provide optimal protection for NHBD heart. Key words: Heart arrest,induced; HOE-642; Nicorandil; Heart transplantation

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