Structural and ultrastructural study of the myocardium after 24-hour preservation in University of Wisconsin solution

This study deals with myocardial preservation after 24 hours of continuous perfusion with University of Wisconsin (UW) solution, focusing on the morphological changes produced by preservation and reperfusion, and their possible relationship to the composition of the solution and the immediate hemodynamic findings after orthotopic heart transplantation in dogs. Following preservation, the histological images of the myocardium were normal in almost every case. After revascularization, although 50% of the hearts recovered preoperative functional levels, there were relevant histological changes in all of them. These changes consisted of interstitial edema, damage to at least 50% of the mitochondria, presence of contraction bands, loss of intercellular junction structure and vasoconstriction. According to these results, the association of continuous perfusion and UW solution appears to be effective during the ischemic period of prolonged myocardial preservation, but not during reperfusion. Perhaps the proportion of viable hearts could be increased by preventing vasoconstriction.