University of Wisconsin versus St. Thomas' Hospital solution for human donor heart preservation.
Prolongation of the safe period of ischemia of the heart is an efficient way to overcome donor organ shortage, as demonstrated in renal and hepatic transplantation. We present the results of a prospective, randomized study comparing preservation with University of Wisconsin solution (UWS) versus St. Thomas' Hospital solution (STS) in clinical heart transplantation. A total of 39 patients were enrolled in the study (n = 20 for UWS and n = 19 for STS). Hemodynamic, electron microscopic, and biochemical evaluation did not reveal any significant differences in postoperative myocardial performance. Only the number of intraoperative defibrillations (0.82 for UWS versus 1.7 for STS) and the rhythm stability after reperfusion (13/20 UWS hearts versus 6/19 STS hearts in sinus rhythm) were significantly different. Heart preservation with UWS and STS appears to be of comparable efficacy at mean ischemic times of less than 4 hours.
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
S
S
Demertzis
J
J
Wippermann
J
J
Schaper
T
T
Wahlers
H J
HJ
Schäfers
I
I
Wagenbreth
B
B
Hausen
A
A
Haverich
D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D001639:Bicarbonates / Q000008:administration & dosage / Q000627:therapeutic use; D002122:Calcium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D002302:Cardiac Output; D002304:Cardiac Pacing, Artificial; D002314:Cardioplegic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D003326:Coronary Circulation; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005978:Glutathione; D016027:Heart Transplantation / Q000379:methods / Q000473:pathology; D006801:Humans; D007328:Insulin; D007527:Isoenzymes; D007552:Isotonic Solutions / Q000627:therapeutic use; D008274:Magnesium / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D016343:Monitoring, Intraoperative; D009206:Myocardium / Q000473:pathology; D019188:Organ Preservation Solutions; D011189:Potassium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011887:Raffinose; D000077325:Ringer's Lactate; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D012996:Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D015996:Survival Rate; D013997:Time Factors; D014021:Tissue Preservation
D001639:Bicarbonates; D002314:Cardioplegic Solutions; D007328:Insulin; D007527:Isoenzymes; D007552:Isotonic Solutions; D019188:Organ Preservation Solutions; D000077325:Ringer's Lactate; D012996:Solutions; C041711:St. Thomas' Hospital cardioplegic solution; C055206:University of Wisconsin-lactobionate solution; D012965:Sodium Chloride; D000493:Allopurinol; D011189:Potassium Chloride; D003402:Creatine Kinase; D005978:Glutathione; D008274:Magnesium; D000241:Adenosine; D002122:Calcium Chloride; D011887:Raffinose