Extended cardiopulmonary preservation: University of Wisconsin solution versus Bretschneider's cardioplegic solution.
Application of the University of Wisconsin cold storage solution has rapidly expanded to include medium-term to long-term preservation of virtually all intraabdominal organs. Its use in intrathoracic organ transplantation has also been suggested. We therefore examined the efficacy of the University of Wisconsin solution in a primate allotransplantation model for preservation of hearts, and as a simple single-solution system for static preservation of heart-lung blocks, for periods of ischemia ranging from 6 to 24 hours. For comparison, we employed the histidine-tryptophane-ketoglutarate cardioplegic solution of Bretschneider. University of Wisconsin solution provided superior results with regard to clinical outcome and hemodynamic recovery of hearts after ischemic periods of up to 16 hours. This was in contrast to Bretschneider's solution, which allowed storage of hearts for periods of only up to 10 hours. Heart-lung blocks were equally well preserved with either University of Wisconsin or Bretschneider's solution after 6 to 12 hours, although the University of Wisconsin solution group exhibited a more notable increase in pulmonary water content. This was in accordance with histological data, which suggested that, although hemodynamic recovery of hearts stored for periods longer than 10 hours was poor, preservation of pulmonary ultrastructure was far superior using Bretschneider's solution as compared with University of Wisconsin solution after an ischemic period of up to 16 hours.
Human
P A
PA
Department of Cardiotheoracic Surgery, University of Cape Town Medical School, Republic of South Africa.
Holl
J
J
Vosloo
S
S
Hewitson
J
J
Brink
J G
JG
Reichenspurner
H
H
Boehm
D
D
Rose
A G
AG
Odell
J A
JA
Reichart
B
B
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D001834:Body Water / Q000737:chemistry; D002302:Cardiac Output / Q000187:drug effects; D002314:Cardioplegic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D002395:Catecholamines / Q000627:therapeutic use; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D005978:Glutathione; D006324:Heart Arrest, Induced; D016027:Heart Transplantation / Q000379:methods / Q000473:pathology; D016041:Heart-Lung Transplantation / Q000379:methods / Q000473:pathology; D006982:Hypertonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin; D007511:Ischemia; D008168:Lung / Q000737:chemistry / Q000187:drug effects / Q000473:pathology; D008353:Mannitol / Q000008:administration & dosage / Q000627:therapeutic use; D008991:Monitoring, Physiologic; D009206:Myocardium / Q000737:chemistry / Q000473:pathology; D019188:Organ Preservation Solutions; D010215:Papio; D011175:Positive-Pressure Respiration; D011189:Potassium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D011343:Procaine / Q000008:administration & dosage / Q000627:therapeutic use; D011887:Raffinose; D012996:Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D013318:Stroke Volume / Q000187:drug effects; D015996:Survival Rate; D013997:Time Factors; D014021:Tissue Preservation / Q000379:methods; D016277:Ventricular Function, Left / Q000187:drug effects
C039984:Bretschneider cardioplegic solution; D002314:Cardioplegic Solutions; D002395:Catecholamines; D006982:Hypertonic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; D008353:Mannitol; D011343:Procaine; D000493:Allopurinol; D011189:Potassium Chloride; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose