Solutions for tissue preservation and bloodless surgery and methods using same

The blood substitute of claim 12 wherein said maintenance solution (B) comprises:

• (1) said second aqueous solution of electrolytes;
• (2) an amount effective to counteract cell swelling during cold exposure of said impermeant anion;
• (3) from about 10 mM to about 20 mM of mannitol;
• (4) an amount effective to maintain oncotic pressure equivalent to that of blood plasma of said macromolecular oncotic agent selected from the group consisting of human serum albumin, polysaccharide having a molecular weight in the range of from about 30,000 to about 70,000, and artificial colloid derived from waxy starch;
• (5) from about 1 mM to about 1M of said nutritive sugar;
• (6) from about 0.5 mM to about 2 mM of said ATP substrate;
• and
• (7) said biologically acceptable pH buffer;
• and
• (8) up to about 5 mM of glutathione.

A method of performing a bloodless hypothermic procedure upon a euthermic subject in need thereof comprising the steps of:

• (a) lowering the subject's core body temperature to a temperature above ice point and insufficient to cause cardiac fibrillation;
• (b) perfusing the subject with an amount of a purge solution in an amount sufficient to remove essentially all of the subject's circulating blood, said purge solution comprising (1) a first aqueous solution of electrolytes at about physiological concentrations, (2) a macromolecular oncotic agent effective to maintain oncotic pressure equivalent to that of blood plasma, (3) a biologically acceptable pH buffer effective to prevent acidosis under physiological and hypothermic conditions, (4) a nutritive effective amount of simple nutritive sugar, (5) a substrate for the regeneration of ATP and (6) glutathione and continuing perfusing until replaced with a maintenance solution;
• (c) replacing essentially all of said circulating purge solution with a maintenance solution comprising (1) a second aqueous solution of electrolyte comprising potassium ions at a concentration range of from 35 to 45 mM sufficient to arrest cardiac contractile activity abruptly, sodium ions at a concentration range of from 80 to 120 mM, magnesium ions at a concentration range of from 2 to 10 mM, and calcium ions at a concentration range of from 0.01 to 0.07 mM, (4) a macromolecular oncotic agent having a size sufficiently large to limit escape from the circulation system and effective to maintain oncotic pressure equivalent to that of blood plasma and selected from the group consisting of human serum albumin, polysaccharide and colloidal starch, (7) a biological pH buffer effective under physiological and hypothermic conditions, (5) a nutritive effective amount of at least one simple nutritive sugar, (3) an impermeant and hydroxyl radical scavenging effective amount of mannitol, (2) impermeant anion impermeable to cell membranes and effective to counteract cell swelling during cold exposure, said impermeant ion being at least one member selected from the group consisting of lactobionate, gluconate, citrate and glycerophosphate, and (6) a substrate effective for the regeneration of ATP said substrate being at least one member selected from the group consisting of adenosine, fructose, ribose and adenine, and optionally, (8) glutathione;
• (d) performing the hypothermic procedure on the patient;
• (e) replacing essentially all of the circulating maintenance solution with a purge solution and
• (f) reintroducing blood into the subject.