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Updated: Jul 4, 2026
Assessment of Sarcoplasmic Reticulum Calcium Reserve and Intracellular Diastolic Calcium Removal in Isolated Ventricular Cardiomyocytes
Published on: September 18, 2017
Calcium-supplemented University of Wisconsin solution in long-term myocardial preservation
Lourdes Alvarez-Ayuso1, Soledad García Gómez-Heras, Jorge R Roda
1Department of Experimental Surgery, Puerta de Hierro University Hospital, Madrid, Spain. lalvarez.hpth@salud.madrid.org
Insights
Adding calcium to University of Wisconsin solution for heart preservation worsened outcomes. This study found calcium overload and increased enzyme release, making it inadvisable for long-term myocardial perfusion.
Area of Science:
- Cardiology
- Transplantation Biology
- Biochemistry
Background:
- Long-term myocardial perfusion is crucial for heart transplantation.
- University of Wisconsin (UW) solution is a standard preservation fluid.
- The role of calcium in UW solution during extended preservation requires clarification.
Purpose of the Study:
- To evaluate the impact of calcium addition to UW solution on long-term myocardial perfusion.
- To assess the effects of calcium on heart preservation in a heterotopic transplantation model.
Main Methods:
- A heterotopic pig heart transplantation model was used.
- Donor hearts were preserved for 24 hours with UW solution, with or without 2.4 mmol/L calcium.
- Solution parameters, enzyme release, and ventricular morphology were analyzed post-reperfusion.
Main Results:
- Calcium addition improved intercellular junction integrity but caused intracellular calcium overload.
- Increased enzyme release (LDH, CK) was observed in the calcium-supplemented group (p<0.01).
- Significant ventricular contracture, hardness, stiffness, and disorganized actin structure were noted with calcium.
Conclusions:
- Calcium addition to UW solution promotes intracellular calcium overload and cellular damage during 24-hour heart preservation.
- The detrimental effects include increased enzyme release and severe morphological changes.
- Calcium supplementation is not recommended for long-term myocardial perfusion with UW solution under these conditions.
Abstract:
The purpose of this study was to assess the effects of the addition of calcium to University of Wisconsin solution in long-term myocardial perfusion. In a heterotopic heart transplantation model, performed in pigs, the donor heart was preserved for 24 hours by means of continuous perfusion in this solution, without (24hUW group) or with calcium, 2.4 mmol/L (24hUW+Ca). During this period, the oxygenation and pH of the solution were measured, as were the calcium and lactate concentrations and enzyme release. After two hours of reperfusion, samples were collected from both ventricles for the morphological study. In the control group, there were no signs that reperfusion had triggered the calcium paradox. The addition of this cation to the preservation solution improved the intercellular junction integrity but, at the same time, favored intracellular calcium overload. This is manifested by increased enzyme release during preservation (LDH: 242+/-95 vs 140+/-25; CK: 668+/-371 vs 299+/-83 (U/L). p<0.01 in both cases) and signs of ventricular contracture: hardness and stiffness were significantly more prominent than in the group without calcium supplementation. Moreover, in comparison with the control group, the structural morphology of 24hUW+Ca is characterized by the more prominent and extensive presence of contraction bands and disorganized actin structure. Thus, under the experimental conditions employed in this study, we consider the addition of calcium to Wisconsin solution to be unadvisable.
