title: A new protective solution for hypothermic storage of free vein grafts in cardiovascular surgery.
abstract: In order to reduce the operative injury of the endothelium in free reversed vein grafts, cultured human endothelial cells were used to test the optimal concentration of the constituents of a flushing solution for improved protection of the endothelium. The following solution proved to be the most suitable when tested at 20 degrees C; mannitol 160 mmol l-1, glucose 15 mmol l-1, NaCl 30 mmol l-1, KHCO3 5 mmol l-1, K2SO4 10 mmol l-1, KH2PO4 4 mmol l-1, MgSO4 20 mmol l-1, CaCl2 1.5 mmol l-1, potassium citrate 1.0 mmol l-1, Pluronic F-68 20 mg l-1, HEPES 4 mmol l-1, HEPES-Na 6 mmol l-1, pH 7.25, osmolality 325 mosmol kg-1 H2O. When endothelial cell injury was measured by a 51Cr-release assay, the new solution protected human endothelial cells in culture during hypothermic incubation better than isotonic NaCl, St Thomas' cardioplegic solution or Krebs-Henseleit's buffer. Transmission and scanning electron microscopy showed that the endothelium of human saphenous vein grafts was well preserved following 6 h of incubation at 20 degrees C with the new solution. As determined by morphometry using scanning electron microscopy, the endothelium of free porcine vein grafts was better preserved after incubation for 2 h at 20 degrees C with the new solution than with either isotonic NaCl (p = 0.02) or diluted, heparinized blood (p = 0.02) as the incubation medium, all cases observed following 2 h of subsequent arterial flow. The present study indicates that the endothelium of free vein grafts can be well protected against hypothermia when the flushing and irrigation fluid has a composition favouring endothelial protection. It appears likely that such treatment of vein grafts will reduce the frequency of vein graft narrowing and occlusion, post-operatively.
authors.affiliation: Institute of Medical Biology, University of Tromsø, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Solberg
authors.forename: T
authors.initials: T
authors.lastname: Larsen
authors.forename: A
authors.initials: A
authors.lastname: Småbrekke
authors.forename: J H
authors.initials: JH
authors.lastname: Brox
authors.forename: K
authors.initials: K
authors.lastname: Bertheussen
authors.forename: D
authors.initials: D
authors.lastname: Sørlie
authors.forename: B
authors.initials: B
authors.lastname: Osterud
authors.forename: L
authors.initials: L
authors.lastname: Jørgensen
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D003080:Cold Temperature; D004730:Endothelium, Vascular / Q000502:physiology*; D006801:Humans; D012996:Solutions; D013552:Swine; D014021:Tissue Preservation; D014680:Veins / Q000637:transplantation*
chemical_list: D012996:Solutions