Cardiac preservation by continuous perfusion of the University of Wisconsin solution

Recent studies have shown that the University of Wisconsin (UW) solution may be superior to standard solutions in preserving the isolated heart before transplantation. The authors compared the UW solution with a modified Krebs-Henseleit solution in a continuous hypothermic coronary perfusion model. Hearts from mongrel dogs were rapidly excised after hyperkalemic arrest with standard cardioplegia and were mounted in a perfusion apparatus for 24 hours. Twelve hearts were perfused with the Belzer UW solution (group 1), and 15 hearts were perfused with a modified Krebs-Henseleit solution (group 2). The hearts were transplanted in a cross-circulation model, and parameters of function (developed pressure [dP] and rate of pressure development [+/- dP/dt]) were measured. Mean (+/- SEM) developed pressure was 80 +/- 7 mm Hg in group 1 and 56 +/- 9 mm Hg in group 2 (p less than 0.05). The +dP/dt was 1433 +/- 126 mm Hg/s in group 1 and 843 +/- 154 mm Hg/s in group 2 (p less than 0.005), and the -dP/dt was 958 +/- 110 mm Hg/s in group 1 and 676 +/- 106 mm Hg/s in group 2 (p less than 0.05). The UW-preserved hearts also required fewer defibrillations (0.75 +/- 0.13) to establish a stable rhythm than the control hearts (5.87 +/- 2.07, p less than or equal to 0.02). There were no significant differences in weight gain, coronary resistance or creatine phosphokinase levels between the two groups. The authors conclude that the UW solution provides better preservation of function than a modified Krebs-Henseleit solution for continuous coronary perfusion.