CPC A01N 1/0226 (2013.01) | 6 Claims |
1. A method of preserving a donor heart for transplantation after cardiac death by microperfusion of organ vasculature at 2 to 6 degrees C. comprising:
arresting the donor heart using a first cardioplegic aqueous solution comprising St. Thomas's Hospital No. 2 solution containing:
(a) 14 mM sodium-L-aspartate;
(b) 5 mg/L adenosine;
(c) 100 units/L regular insulin; and
(d) 5 mg/L cyclosporine;
harvesting the donor heart;
flushing the harvested donor heart with a second cardioplegic aqueous solution comprising St. Thomas's Hospital No. 2 solution containing:
(a) 14 mM sodium-L-aspartate;
(b) 10 mM sodium bicarbonate; and
(c) 7.6 mg/L-cariporide or equivalent sodium-hydrogen ion exchange inhibitor;
preparing a sterile aqueous solution for microperfusion containing:
(a) between 10 and 20 mM potassium chloride;
(b) between 5 and 10 mM magnesium;
(c) between 0.2 and 1.0 mM calcium;
(d) between 10 and 40 mM Tris(hydroxymethyl)aminomethane hydrochloride (Tris or THAM), 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HE PES), 3-(N-morpholino)propanesulfonic acid (MOPS), 2-(N-morpholino)ethanesulfonic acid (MES), N,N-bis-(2-hydroxyethyl)-2-aminoethanesulfonic acid (BES), or Ntris(hydroxymethyl)methyl-2-aminoethanesulfonic acid (TES);
(e) between 10 and 30 mM sodium bicarbonate, for enhancing out-flow of CO2 from cells;
(f) between 1 and 40 mM aspartate;
(g) between 1 and 30 mM glucose;
(h) between 1 and 20 mM adenosine, cAMP or cGMP;
(i) between 30 and 100 mM lactobionate; and
(k) a diluent;
injecting into the sterile aqueous solution, a mixture containing:
(a) between 1 and 20 units/L insulin;
(b) between 1 and 10 mM fructose diphosphate or a salt thereof; and
(c) between 1 and 10 mM reduced glutathione;
and
microperfusing the donor heart with the injected sterile aqueous solution while maintaining the donor heart and the injected sterile aqueous solution at a temperature between 2 and 6 degrees C., the microperfusing using only gravity to draw the injected sterile aqueous solution through the donor heart in a single microperfusion pass, wherein ionic strength of sodium in the sterile aqueous solution is maintained between 110 and 120 mM.
|