| Objective: Heart transplantation is the mainstay of surgical treatment of endstage heart disease,and with the acceleration of the aging of the global population,the number of patients with end-stage heart disease continues to increase,and the number of people waiting for heart transplantation is far greater than the number of heart donors.Therefore,in addition to advocating for heart donation,ex vivo heart preservation techniques need to be improved to expand the use of limbic donor hearts.Continuous perfusion heart non-stop preservation is currently the most effective ex vivo heart preservation technology,domestic and foreign research on continuous perfusion cardiac non-stop preservation is gradually carried out,but so far there is no research report on the application of traditional Chinese medicine to continuous perfusion heart non-stop preservation.In order to further optimize the method of ex vivo heart preservation and reduce the damage of ex vivo heart before transplantation,shenfu injection(SFI),a traditional Chinese medicine preparation with qi and solidification effect,was added to the perfusion solution and continuously perfused the ex vivo donor heart without beating to observe its effect on the preservation of ex vivo donor heart.Methods: 12 healthy Bama miniature pigs that met the research criteria were randomly divided into the Shenfu group(n=6)and the control group(n=6).Cardiac resection was performed under general anesthesia to obtain the donor heart,and the obtained donor heart was preserved with continuous perfusion and beating heart.In the Shenfu group,SFI was added to the perfusion solution and preserved by continuous perfusion for 8 hours without beating the heart.Observe the values of perfusion pressure and perfusion flow rate at each time period during the perfusion process of the isolated hearts of the two groups,and at the same time detect the serum obtained at each time period during the perfusion period,and observe the concentration of free hemoglobin in the serum.Results: By measuring the concentration of free hemoglobin in the perfusate of Bama minipig heart donated by continuous perfusion and beating heart,the results showed that there was no statistical difference in the concentration of free hemoglobin in the perfusion solution of the Shenfu group compared with the control group(P=0.15>0.05),but after subtracting the T0 free hemoglobin concentration from the T1～T8 free hemoglobin concentration,a statistical analysis can be found that the difference between the free hemoglobin concentration and the T0 free hemoglobin concentration of the Shenfu group and the control group is statistically different(P= 0.01<0.05).According to the results of the observation indicators,in the hearts obtained from Bama miniature pigs obtained from continuous perfusion heart beating preservation,there was no significant difference in perfusion pressure between the Shenfu group and the control group at each time point(P=0.23>0.05).The perfusate flow required at each time point in the attached group was significantly different from that in the control group(P=0.01<0.05).Conclusions: 1.Adding SFI to the beating donor heart with continuous perfusion can reduce the concentration of free hemoglobin in the perfusion fluid.It is considered that SFI can protect red blood cells by improving physiological factors and/or non-physiological factors.2.Adding SFI in the process of continuous perfusion heart beating heart preservation can reduce the perfusion flow rate.It is considered that SFI can reduce the perfusion resistance and alleviate microcirculation disturbance by reducing oxidative stress response and the release of inflammatory factors.3.Adding SFI in the process of continuous perfusion heart beating heart preservation can reduce red blood cell damage and alleviate microcirculation disturbance,thereby achieving the effect of protecting the isolated pig heart. |
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