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Heart and lung preservation

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Procurement, Preservation and Allocation of Vascularized Organs

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Abstract

Preservation of the heart and lung has lagged behind that of the intra-abdominal organs. Although the first heart transplant was performed close to three decades ago, the maximum safe preservation period for both heart and lung remains at approximately 6 h [1,2]. This slow progress in the case of the heart is due to the difficulty in countering the effects of loss of the Ca2+ regulatory mechanisms produced by ischaemia, and in the case of the lung it results from the fragility of the alveolar structure [3,4]. In the heart this damage usually manifests itself as low cardiac output and in the lung as postoperative deterioration in circulatory oxygen tension, decreased compliance and increased pulmonary vascular resistance [5,6]. For heart preservation the general consensus favours the use of extracellular solutions (St Thomas II), whereas an intracellular formulation is preferred for the storage of lungs [7,8]. Many modifications of these solutions have been tried, including the addition, replacement or removal of colloids, pharmacological agents, biological and synthetic antioxidants, antiplatelet activating factor, calcium antagonists and vasodilators such as prostaglandins PGE1 and PGI2 [9–11]. Critical comparisons among these solutions is complicated by the numerous methods used for testing. The ultimate test, of course, remains orthotopic transplantation for hearts and unilateral, double, or heart–lung transplantation for lungs.

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Authors
  1. Winston N. Wicomb
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Editors and Affiliations

  1. Department of Transplantation, California Pacific Medical Center, San Francisco, California, USA

    G. M. Collins

  2. Transplantation Pavillon V, HĂ´pital Edouard Herriot, Lyon, France

    J. M. Dubernard

  3. Division of Transplant Surgery, Department of Surgery, Klinikum Grosshadern, University of Munich, Munich, Germany

    W. Land

  4. Eurotransplant Foundation, Leiden, The Netherlands

    G. G. Persijn

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© 1997 Springer Science+Business Media Dordrecht

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Wicomb, W.N. (1997). Heart and lung preservation. In: Collins, G.M., Dubernard, J.M., Land, W., Persijn, G.G. (eds) Procurement, Preservation and Allocation of Vascularized Organs. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5422-2_19

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  • DOI: https://doi.org/10.1007/978-94-011-5422-2_19

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6280-0

  • Online ISBN: 978-94-011-5422-2

  • eBook Packages: Springer Book Archive

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