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Ann Thorac Surg 1998;65:24-27
© 1998 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Metabolic Detriment in Donor Heart Valves Induced by Ischemia and Cryopreservation

Jen-Her Lu, MD, PhD, Yen Chang, MD, Wen-Hu Hsu, MD, Betau Hwang, MD, Chuh-Khiun Chong, MS, Chi-Chin Wu, MS, Ping-Zen Yang, VD, PhD, Hsung Hsing-Wen, PhD

Division of Pediatric Cardiology, Section of Thoracic and Cardiovascular Surgery, Veterans General Hospital–Taipei, National Yang-Ming University, Taipei, Taiwan, Republic of China
Department of Comparative Medicine, Pig Research Institute, Miaoli, Taiwan, Republic of China

Accepted for publication May 15, 1997.

Dr Lu, Division of Pediatric Cardiology, Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, ROC.

Background. The injury resulting from postmortem ischemia is a critical deterrent to the availability of donor valves. Using the reduction of XTT-tetrazolium salt as a marker of metabolic sequelae, we assessed the injurious effect of ischemia and the metabolic sequelae in 156 porcine semilunar leaflets.

Methods. The leaflets were randomly allocated to noncryoprocessed (n = 72) or cryoprocessed (n = 72) groups. At each preservation temperature of 4°C, 24°C, or 37°C, 24 leaflets each were exposed to one of four storage periods of 9, 17, 30, or 60 hours. Twelve fresh aortic leaflets served as baseline reference samples.

Results. There was a progressive loss in the metabolic functioning of valve leaflet cells in both noncryopreserved and cryopreserved tissue as the storage times increased. Cryopreserved tissue showed a greater loss of function than noncryopreserved tissue did. The metabolic injury was mainly a consequence of cryoprocessing. The greatest loss in metabolic functioning occurred in the valves stored for 60 hours. The least favorable combination of variables was cryopreservation and a precryopreservation storage time of 60 hours.

Conclusions. We conclude that 30- to 60-hour delays do not have a significant metabolic effect on cardiac leaflets. Thus it may be possible to safely extend the permissible ischemic periods after organ harvest.






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