Extracellular and standard University of Wisconsin solutions provide equivalent preservation of myocardial function.
The deleterious effect of hyperkalemic cardioplegic solutions on coronary endothelium has been documented and has also been demonstrated with University of Wisconsin solution. We evaluated a new extracellular University of Wisconsin formulation for efficacy in heart preservation. Six neonatal piglet hearts were arrested with and stored in the standard intracellular University of Wisconsin solution (group 1: K+ 125 mEq/L, Na+ 29 mEq/L). Six piglet hearts were preserved for 24 hours with an extracellular University of Wisconsin solution that differed only in the concentrations of potassium and sodium (group 2: K+ 25 mEq/L, Na+ 129 mEq/L). Hearts underwent modified reperfusion with leukocyte-depleted aspartate-glutamate enriched blood cardioplegic solution followed by conversion to a left-sided working mode on a Langendorff circuit with perfusion from a support pig. Stroke work index was calculated at left ventricular end-diastolic pressures of 3, 6, 9, and 12 mm Hg. Sixty minutes after reperfusion, there was no significant difference in stroke work index between group 1 (16.4 +/- 1.9 x 1000 erg/gm) and group 2 (15.3 +/- 2.7 x 1000 erg/gm). There was also no significant difference in high-energy phosphate stores or myocardial water content between the two groups. Extracellular University of Wisconsin solution provides myocardial preservation equivalent to standard University of Wisconsin solution while preventing exposure of coronary endothelium to high levels of potassium, which justifies its use in clinical heart transplantation.
Drinkwater
D C
DC
Department of Surgery, University of California at Los Angeles School of Medicine, USA.
Ziv
E T
ET
Laks
H
H
Lee
J R
JR
Bhuta
S
S
Rudis
E
E
Chang
P
P
D000241:Adenosine / Q000737:chemistry / Q000494:pharmacology; D000493:Allopurinol / Q000737:chemistry / Q000494:pharmacology; D000818:Animals; D001834:Body Water / Q000378:metabolism; D003331:Coronary Vessels / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism; D005110:Extracellular Space / Q000737:chemistry; D005978:Glutathione / Q000737:chemistry / Q000494:pharmacology; D006321:Heart / Q000502:physiology*; D066298:In Vitro Techniques; D007328:Insulin / Q000737:chemistry / Q000494:pharmacology; D009206:Myocardium / Q000378:metabolism / Q000648:ultrastructure; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D010477:Perfusion; D010710:Phosphates / Q000378:metabolism; D011188:Potassium / Q000008:administration & dosage / Q000378:metabolism; D011887:Raffinose / Q000737:chemistry / Q000494:pharmacology; D012964:Sodium / Q000008:administration & dosage; D013552:Swine; D016277:Ventricular Function, Left; D017725:Ventricular Pressure
D007328:Insulin; D019188:Organ Preservation Solutions; D010710:Phosphates; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D012964:Sodium; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D011188:Potassium