[Evaluation of a new preservation solution for hypothermic heart transplant].
OBJECTIVE
One of the major problems encountered in heart transplant is the limited cardiac preservation time. The time limit from the moment the donor heart is removed to the transplant itself is 4-6 hours at maximum. Extending the preservation time would therefore provide access to a larger pool of donors, and also permit long-distance (transfrontier) organ transfer. To attain this aim, a number of different cardiac preservation solutions have been proposed and evaluated either clinically or experimentally; however, no consensus has yet been reached by the various heart transplant teams involved. As finding an optimal solution is of major importance, the aim of the present study was therefore to assess the efficacy of several cardiac preservation solutions: the University of Wisconsin solutions (UW-1 and UW-1 + calcium = UW-2), the Saint-Thomas' Hospital solution (STH-1) and a new solution (NS) developed by our laboratory.


METHODS
Male Wistar rats (n = 60) were anesthetized by i.m. injection of pentobarbitol, and randomized into six groups, i.e., NS (group I), STH-1 (group II), UW-1 (group III), UW-2 (group IV), saline solution, NaCl (group V), and controls (group VI). All the hearts except those in the control group were preserved by immersion (8 hours, 4 degrees C) in the different solutions (n = 10/group). The hearts were either a) reperfused in Langendorff mode (functional assessment, n = 5/group); or b) frozen (energetic assessment, n = 5/group).


RESULTS
The hearts treated with NaCl displayed arrhythmia and a collapsed mean left ventricular pressure throughout the reperfusion period (3.6 +/- 1.3 mmHg) compared to the NS hearts and the control group (97 +/- 2.6 and 122 +/- 1.9 respectively), while the STH-1, UW-1 and UW-2 hearts showed an intermediate-range ventricular function (48 +/- 4; 39.9 +/- 4.1; and 69 +/- 1.8 respectively). Creatine kinase levels were higher in the STH-1 and NaCl groups (541.9 +/- 168 and 1,080.8 +/- 126.2 IU/L respectively). The energetic charge was significantly lower in the NaCl and UW-2 groups (P = 0.001) compared to the control, NS, STH-1 and UW-1 groups.


CONCLUSIONS
It was found that the composition of the respective solutions had a major effect on the the quality of myocardial preservation. Compared to the other solutions tested in this study, the NS solution was found to be optimal for the preservation of isolated hypothermic rat hearts.
Michel
P
P
Unité de recherche INSERM-U121, 22, avenue du Doyen Lépine, 69675 Bron, France.
Hadour
G
G
Chiari
P
P
Rodriguez
C
C
Ferrera
R
R
D000818:Animals; D016027:Heart Transplantation; D007036:Hypothermia, Induced; D008297:Male; D019188:Organ Preservation Solutions; D051381:Rats; D017208:Rats, Wistar
D019188:Organ Preservation Solutions