Donor Shock and Its Influence on Canine Cadaver Heart Transplants

¹ Stanford University School of Medicine
² Assistant Professor of Surgery, Stanford University School of Medicine and Chief of Cardiovascular Surgery, Veterans Administration Hospital, Palo Alto, California

In this study the effects of premortem hypotension and postmortem anoxia on the viability of canine cadaver hearts were evaluated. Donor dogs were maintained in hemorrhagic shock for either 30 minutes or two hours preceding death. Postmortem hearts were then subjected to total anoxia for 30 minutes at 37° C. Four experimental groups were considered: 1) 30 minutes postmortem anoxia alone; 2) two hours premortem shock alone; 3) 30 minutes premortem shock and 30 minutes postmortem anoxia; and 4) two hours premortem shock and 30 minutes postmortem anoxia. Viability was determined by performance during resuscitative intermediate host perfusion and survival follawing orthotopic homotransplantation. Nine of nine recipient animals survived orthotopic transplantation in groups 1, 2, and 3, whereas none of three host dogs survived transplantation with group 4 hearts. These results indicate that a prolonged interval of premortem shock when in combination with a brief period of postmortem anoxia adversely influences the viability of canine cadaver hearts.