This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Van Dobbenburgh, J. O. Articles by Van Echteld, C. J.A. Search for Related Content PubMed PubMed Citation Articles by Van Dobbenburgh, J. O. Articles by Van Echteld, C. J.A.

(Circulation. 1996;94:2831-2836.)
© 1996 American Heart Association, Inc.

Articles

Functional Recovery After Human Heart Transplantation Is Related to the Metabolic Condition of the Hypothermic Donor Heart

J. Onno Van Dobbenburgh, MD, PhD; Jaap R. Lahpor, MD, PhD; Stephen R. Woolley, MD; Nicolaas de Jonge, MD; Corinne Klopping, MD; Cees J.A. Van Echteld, PhD

the Heart Lung Institute, Departments of Cardiology (J.O. Van D., N. de J., C.K., C.J.A. Van E.) and Cardiothoracic Surgery (J.R.L., S.R.W.), University Hospital, and the Interuniversity Cardiology Institute of The Netherlands (J.O. Van D., C.J.A. Van E.), Utrecht.

Correspondence to Cees J.A. Van Echteld, PhD, University Hospital Utrecht, Heart Lung Institute (Room G02.523), Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. E-mail c.j.a.vanechteld@hli.azu.nl.

Background Although strict selection criteria are being used for the acceptance of human donor hearts for transplantation, problems with respect to functional recovery on reperfusion sometimes still occur. Therefore, evaluation of the viability of a human donor heart before implantation during heart transplantation may be of great value.

Methods and Results In the present study, the energy metabolism of 25 excised human donor hearts arrested with St Thomas' Hospital No. 2 cardioplegic solution was evaluated noninvasively by use of ³¹P magnetic resonance spectroscopy (MRS) before implantation and was correlated with myocardial function measured with thermodilution in heart transplant patients. No significant correlation was observed between the cardiac index of heart transplant patients during the first hours after transplantation and the phosphocreatine/ATP (r=.13, P=.54), inorganic phosphate/ATP (r=.26, P=.21), phosphomonoesters/ATP (r=.02, P=.92), or phosphocreatine/inorganic phosphate (r=.16, P=.44) ratio or the intracellular pH (r=.06, P=.78) at the time of reperfusion. However, 1 week after transplantation, a significant correlation was observed between the cardiac index and the phosphocreatine/ATP (r=.49, P=.01), phosphomonoesters/ATP (r=.45, P=.02), and phosphocreatine/inorganic phosphate (r=.40, P=.05) ratios at the time of reperfusion. In contrast, the inorganic phosphate/ATP (r=.10, P=.63) ratio and pH (r=.31, P=.13) at the time of reperfusion showed a poor correlation with the cardiac index 1 week after transplantation.

Conclusions Functional recovery after human heart transplantation is related to the metabolic condition of the hypothermic donor heart.

Key Words: transplantation • spectroscopy • phosphates • metabolism

This article has been cited by other articles:

				T. Caus, F. Kober, A. Mouly-Bandini, A. Riberi, D. R. Metras, P. J. Cozzone, and M. Bernard 31P MRS of heart grafts provides metabolic markers of early dysfunction Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 576 - 580. [Abstract] [Full Text] [PDF]

				S. C. Stoica, D. K. Satchithananda, C. Atkinson, P. A. White, A. N. Redington, M. Goddard, T. Kealey, and S. R. Large The energy metabolism in the right and left ventricles of human donor hearts across transplantation Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 503 - 512. [Abstract] [Full Text] [PDF]