Experiences of cardiopulmonary bypass for heart transplantation

Objective: To summarize the experiences of cardiopulmonary bypass (CPB) techniques in 15 patients of orthotopic heart transplantation. Methods: All patients received mild hypothermia and high flow rate perfusion. Effective strategies were taken to protect myocardium, lung, kidney, and blood conservation. The donor hearts were arrested with aorto perfusion using 1 000 ml St. Thomas solution at 4°C, perfused with 1 000 ml University of Wiscosin (UW) solution or Histidin-Tryptophan-Ketoglutarat (HTK) solution at 4°C, and then preserved in ice saline. Ice mud was covered on the donor heart during anastomosis. Low potassium cardioplegia solution was perfused before the unclamping of aorta. Results: The CPB time was (165.2 ± 22.8) min, the warm ischemia time was (7.7 ± 1.7) min, and the cold ischemia time was (142.4 ± 11.5) min. Heart beats was automatically recovered in 10 patients, and was recovered upon defibrillation in 5 patients. Left ventricular ejection fractions were (64.1 ± 4.6)% after one month. All patients survived. Conclusion: Proper CPB management and effective donor heart protection are essential to guarantee the success of heart transplantations.