title: Preservation solution impacts physiologic function and cellular viability of human saphenous vein graft.
abstract: BACKGROUND
  Recent clinical data suggest intraoperative preservation of human saphenous vein (HSV) in normal saline is associated with vein graft failure. We evaluated the influence of several preservation media on acute physiologic function and cellular viability of HSV conduit.
  
  
  METHODS
  Unprepared (UP) HSV obtained from coronary artery bypass graft patients was characterized on a muscle bath after 2-hour storage in 6 solutions: Plasma-Lyte A, 0.9% NaCl (normal saline), University of Wisconsin solution, Celsior solution, autologous whole blood, or glutathione-ascorbic acid L-arginine (GALA) solution. Vascular smooth muscle contractility was assessed after exposure to depolarizing KCl and phenylephrine. The relaxation of phenylephrine-precontracted HSV to sodium nitroprusside and carbachol (endothelial-independent and -dependent relaxation, respectively) was also assessed. Cellular viability was determined via the methyl thiazolyl tetrazolium (MTT) assay. Rat aortae were used to assess the effect of pH during graft preservation on endothelial-dependent relaxation.
  
  
  RESULTS
  Preservation of HSV in normal saline and autologous whole blood impaired contractile responses to KCl relative to UP tissues, whereas preservation in University of Wisconsin solution and Celsior solution enhanced contractile responses (P < .05). Relative to UP tissues, responses to phenylephrine were decreased with preservation in normal saline, whereas preservation in University of Wisconsin solution, Celsior solution, and GALA all potentiated these responses (P < .05). Only preservation in normal saline impaired endothelial-independent relaxation (P = .005). Preservation in Plasma-Lyte A (P = .02), normal saline (P = .002), and University of Wisconsin solution (P = .02) impaired endothelial-dependent relaxation. Normal saline preservation decreased MTT viability index relative to UP tissues (0.02 ± 0.002 mg(-1)0.5 mL(-1) vs 0.033 ± 0.005 mg(-1)0.5 mL(-1); P = .03). Endothelial function was impaired by acidic pH in rat aorta.
  
  
  CONCLUSIONS
  Preservation of HSV in normal saline causes graft injury leading to impaired physiologic function and decreased viability of the HSV. This harm is mitigated by the use of buffered salt solutions as preservation media.
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: eric.s.wise@vanderbilt.edu.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Wise
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN; Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Hocking
authors.affiliation: Department of Cardiothoracic Anesthesiology, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Susan
authors.initials: S
authors.lastname: Eagle
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN; VA Tennessee Valley Healthcare System, Nashville, TN.
authors.forename: Tarek
authors.initials: T
authors.lastname: Absi
authors.affiliation: VA Tennessee Valley Healthcare System, Nashville, TN; Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Padmini
authors.initials: P
authors.lastname: Komalavilas
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Joyce
authors.initials: J
authors.lastname: Cheung-Flynn
authors.affiliation: VA Tennessee Valley Healthcare System, Nashville, TN; Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Brophy
mesh_terms: D000818:Animals; D002470:Cell Survival; D006085:Graft Survival; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000502:physiology; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010043:Outcome and Process Assessment, Health Care; D051381:Rats; D012501:Saphenous Vein / Q000637:transplantation*; D058017:Vascular Grafting; D014664:Vasodilation
chemical_list: D019188:Organ Preservation Solutions