Related Experiment Video
Updated: Mar 30, 2026
Innovative Strategies for Organ Preservation in Heart Transplantation: Uniform Cooling Preservation and Ex-situ Normothermic Perfusion
Published on: November 28, 2025
Three Preservation Solutions for Cold Storage of Heart Allografts: A Systematic Review and Meta-Analysis
Yongnan Li1,2, Shasha Guo1, Gang Liu1
1Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Insights
The University of Wisconsin (UW) solution offers superior heart preservation compared to Celsior and histidine-tryptophan-ketoglutarate (HTK) solutions, improving patient survival and reducing ischemic necrosis in heart transplantation.
Area of Science:
- Transplantation Medicine
- Cardiovascular Surgery
- Organ Preservation
Background:
- Organ preservation solutions are crucial for mitigating ischemia during heart transplantation.
- Evaluating the comparative efficacy of different preservation solutions is essential for optimizing patient outcomes.
Purpose of the Study:
- To systematically review and compare the effectiveness of various organ preservation solutions for heart transplantation.
- To assess the impact of different solutions on patient survival, donor heart function, and mortality.
Main Methods:
- Systematic literature search across major databases (PubMed, Embase, Cochrane Library, etc.) and clinical trial registries.
- Analysis of primary outcomes including patient survival and donor heart dysfunction.
- Evaluation of secondary outcomes such as in-hospital mortality and enzyme gene expression.
Main Results:
- The University of Wisconsin (UW) solution demonstrated significantly improved 30-day and 90-day survival rates compared to Celsior solution.
- Hearts preserved with UW solution showed reduced ischemic necrosis versus Celsior.
- UW solution also showed better survival outcomes than histidine-tryptophan-ketoglutarate (HTK) solution.
- No significant differences were observed in donor heart dysfunction or in-hospital mortality between HTK and Celsior solutions.
Conclusions:
- UW solution provides superior clinical outcomes for heart transplantation during static cold storage compared to Celsior and HTK solutions.
- Celsior and HTK solutions exhibit similar protective effects in donor heart preservation.
Abstract:
Organ preservation solution has been designed to attenuate the detrimental effects during the ischemic period. The aim of this study was to systematically evaluate the evidence comparing preservation solutions for heart preservation. Studies were searched in PubMed, Embase, the Cochrane Library, the Transplant Library, and the International Clinical Trials Registry Platform. The primary outcomes were patient survival and donor heart dysfunction. The secondary outcomes were in-hospital mortality and enzyme gene expression. The University of Wisconsin solution (UW) was associated with a significantly improved survival at 30 days and 90 days (hazard ratio = 1.16, 95% confidence interval [CI] = 1.11-1.22, P < 0.00001; risk difference [RD] = 0.03, 95% CI = 0.01-0.05, P = 0.002), compared with Celsior. Hearts preserved with UW exhibited less ischemic necrosis than those preserved with Celsior (RD = -0.07, 95% CI = -0.08 to 0.05, P < 0.00001). UW was associated with better survival compared with histidine-tryptophan-ketoglutarate solution (HTK). There was no statistical difference in donor heart dysfunction and in-hospital mortality outcomes when comparing HTK with Celsior solution. During static cold storage preservation, this study suggests that UW solution has better clinical outcomes for heart transplantation compared with the other two organ preservation solutions. Besides, the protective effect of Celsior solution is similar to HTK solution in donor heart preservation.
