Chapter 2544 【2544】Time Control Is Very Important

The First Affiliated Hospital of Zhongshan Medicine must have this technical strength, so they don't need to fly over. The doctor who will be in charge of extracting the donor's heart during the operation later will be Dr. Ye Chuanguang.

"Does your doctor have any requirements for our side?" Ye Chuanguang asked.

While talking on the phone, Xie Wanying pulled out the ballpoint pen from her hand.

Seeing this, classmate Wei helped her take out her notebook so that she could write in it.

Xie Wanying wrote down what she wanted to coordinate with the other party for Teacher Cheng to review.

Doctor Cheng Yuchen nodded while watching.

After obtaining the teacher's consent, Xie Wanying said: "First of all, the distance to transport the heart is relatively long and the journey will take a long time. Some preparations require your cooperation, Teacher Ye."

"You're welcome." Ye Chuanguang said frankly, "If you didn't call, we wanted to ask you what your plan was. Do we need to reinfuse the donor heart with cardioplegia solution from the aortic root for preservation?"

"Yes." A great teacher, you don't need to say a word, you can understand it almost instantly.

"But you have to be clear, the cold ischemia time of the heart should not exceed five or six hours." Ye Chuanguang nagged and reminded, don't think that everything will be fine with more preparation steps, at most it will be a little longer .

Cold ischemia can be said to be a proper term in organ transplantation technology. Before talking about cold ischemia, let’s talk about another similar technical term: warm ischemia.

The period of operation before an organ is removed from a donor after cardiac arrest for cold storage is called warm ischemia. Cold ischemia corresponds to the time period from when an organ leaves the donor to when it is transplanted into the recipient, and the most important thing here is the transportation time on the road.

Each organ has an upper limit for warm ischemia and cold ischemia time. For example, the upper limit of warm ischemia and cold ischemia of the heart is the shortest, ten minutes and eight hours respectively. The ten minutes and eight hours here are the super upper limit, which is equivalent to a big adventure. No one can easily afford to take this risk. Therefore, Dr. Ye said that the cold ischemia time should not exceed five or six hours. The warm ischemia time of their hospital to remove the donated heart will be controlled to less than five minutes.

What happened to the infusion of cardioplegia? Here again, when the organ is taken from the donor, the cells are not dead and continue to metabolize. Since the blood flow is interrupted and there is no blood nourishment, the taken out organs will inevitably undergo metabolic damage of self-consumption. It is conceivable that the time period of warm ischemia will cause the most damage to the donor organ, and skilled professional doctors are needed to shorten the operation time as much as possible.

How to protect the donor heart during the cold ischemia stage. From the perspective of medical technology, either the most ideal state is to use mechanical simulation of a normal human body to continuously perfuse the donor heart, so that the damage is minimal. The problem is that long-distance transportation can’t do this at all, so we can only make a second choice and use other methods to reduce the metabolic rate of the donor heart to reduce damage. Therefore, there must be low temperature and other ingredients in the general organ preservation solution to inhibit the metabolism of organ cells.

The energy consumption of the heart is mainly the movement of heart contraction and relaxation and the metabolic composition of myocardial cells. The former accounts for 90% of the total consumption. The use of cardioplegia can stop the mechanical activity of the heart, and the low temperature reduces the metabolism of myocardial cells. The combination of the two is equal to one plus one, and the effect of reducing loss is doubled.

Protecting the myocardium is one aspect.

On the other hand, since the heart is not like the liver and has a special structure, the donor heart and the recipient need multiple anastomoses.