Successful transplantation of cadaver hearts harvested one hour after hypoxic cardiac arrest

Background: A shortage of donor organs in clinical transplantation prompted us to study whether resuscitated 'dead' hearts could be used for successful orthotopic heart transplantation. Methods: Donor hearts were resuscitated with cardiopulmonary bypass after 3 minutes (the control group; n = 8) or 60 minutes (the experimental group; n = 6) of hypoxic cardiac arrest after induction of brain death. Results: All the animals of each group were successfully weaned from cardiopulmonary bypass with 5 μg/kg/min of dopamine 1 hour after transplantation, and cardiac function with or without dopamine was better preserved in the experimental group than the control group (with maximum slope of pressure-volume relationship with dopamine: 198.0% ± 36.8% versus 121.2% ± 47.2%; maximum slope of pressure-volume relationship without dopamine: 130.6% ± 41.5% versus 70.8% ± 21.5% [mean ± standard deviation] as percentage of values after brain death, respectively; p < 0.01 by unpaired t test). Conclusions: These results indicate that cadaver hearts 60 minutes after anoxic arrest can be successfully reanimated and orthotopically engrafted with various methods and drugs.