Review Articles

The Basic Science Aspect of Donor Heart Preservation: A Review

¹ Department of Physiology, University of Minnesota, Minneapolis, Minnesota
² Department of Surgery, University of Minnesota, Minneapolis, Minnesota
³ Department of Surgery, Experimental Surgical Services, University of Minnesota, Minneapolis, Minnesota
⁴ Department of Surgery, Division of Cardiovascular Surgery, University of Minnesota, Minneapolis, Minnesota

^* Address correspondence to: Andrew L. Rivard, MD, Cellular & Integrative Physiology Graduate Program, Department of Physiology, 6-125 Jackson Hall, 420 Delaware Street S.E., University of Minnesota, Minneapolis, MN 55455. E-mail: rivar011@umn.edu

Abstract

In cardiac transplantation, the transport time between harvest and recipient is limited by the viability of the donor heart. The problem of viability is a consistent limitation in cardiac transplantation. Since the 1960s, techniques, including hypothermia, perfusion, oxygenation, and hyperbaria, have been used to prolong the preservation of the transplantable heart. Continuing development of cardioplegic solutions has minimized edema and oxygen radical formation, which have resulted in extension of the donor heart viability. New research into the events leading to necrosis, oncosis, and apoptosis may allow further advancement of protective cardioplegic solutions in combination with technology of transporting the heart. With a prolonged preservation time there is potential to increase the donor pool and ultimately improve post-operative outcomes.