To the Editor: We read with great interest the article by Badiwala et al1 describing donor pretreatment with hypertonic saline as being effective in attenuating primary allograft dysfunction in an experimental porcine heart transplant model. The positive influence of hypertonic saline on enhanced ventricular recovery after storage-related ischemia-reperfusion injury and subsequent transplantation was ascribed to an improvement of early hemodynamics and beneficial immunomodulatory and vasculomodulatory effects.1 A work published by Harada and associates2 might explain the early positive hemodynamic effects. Postischemic dysfunction after short-term global ischemia in isolated blood-perfused dog hearts was caused by a decreased responsiveness of the contractile elements to intracellular …
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