Modulation of calcium ion homeostasis in harvested transplantable hearts
An oxygenated cardioplegic composition for immediate reperfusion of a donor heart after its procurement. The composition comprises an adenosine-lidocaine mixture for causing immediate cessation of the heart's systolic function upon contact; a normokalemic concentration of potassium ions; a concentration of Ca 2+ ions selected to maintain the intracellular level of Ca 2+ ions in the harvested heart muscle cells at about 10 −4 mmol/L; and a pH of 6.9. The oxygenated cardioplegic composition is pre-warmed to about 35° C. and then used for immediate reperfusion of a donor heart for at least three minutes after its procurement.
1. A cardioplegic composition comprising:
400 μmol/L of adenosine;
50 μmol/L of lidocaine;
10.0 mmol/L of glucose;
131.8 mmol/L of NaCl;
5.9 mmol/L of KCl;
14.0 mmol/L of NaHCO 3 ;
1.2 mmol/L of NaH 2 PO 4 ;
0.22 mmol/L of CaCl 2 ;
13.0 mmol/L of MgCl 2 ;
10.0 IU/L of insulin
120.0 mmol/L of D-mannitol;
1.0 mmol/L of pyruvate; and
3.0 mmol/L of reduced glutathione,
wherein the cardioplegic composition has a pH of 6.6 to 6.9.
2. A method comprising:
bathing and reperfusing a donor heart in the cardioplegic composition of claim 1 immediately after procurement of the donor heart, wherein said cardioplegic composition is oxygenated and warmed to about 35° C. prior to use.
3. The cardioplegic composition of claim 1 , wherein the pH is 6.9.
4. The method of claim 2 , wherein the pH of the cardioplegic composition is 6.9.
5. The method of claim 2 , comprising bathing the donor heart in the oxygenated and warmed cardioplegic composition during procurement of the donor heart.
6. The method of claim 5 , wherein the pH of the cardioplegic composition is 6.9.