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Valluvan Jeevanandam
Mark L. Barr
Joseph S. Auteri
Juan A. Sanchez
Gary Y. Ott
Craig R. Smith
Eric A. Rose
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Ann Thorac Surg 1991;52:1213-1216
© 1991 The Society of Thoracic Surgeons

Articles

University of Wisconsin solution for human donor heart preservation: Initial clinical experience

Valluvan Jeevanandam, MD*, Mark L. Barr, MD, Joseph S. Auteri, MD, Juan A. Sanchez, MD, Gary Y. Ott, MD, Felicia A. Schenkel, RN, Charles Marboe, MD, Craig R. Smith, MD, Eric A. Rose, MD

Departments of Surgery and Pathology, Columbia-Presbyterian Medical Center, New York, New York USA

* Address reprint requests to Dr Jeevanandam, Department of Surgery, Columbia-Presbyterian Medical Center, Box 407, 622 W 168th St, New York, NY 10032 USA.

Although in vitro and primate orthotopic transplant experiments have suggested the superiority of University of Wisconsin solution (UWS) compared with crystalloid cardioplegia and saline solution storage for hypothermic heart preservation, concerns about the viscosity and the high potassium concentration of UWS have precluded its use in human cardiac transplantation. To test the safety and efficacy of UWS, 16 patients received hearts arrested with, flushed with, and stored in UWS at 4 °C for a mean ischemic time of 153.3 ± 30.7 minutes. After reperfusion, the hearts contracted vigorously and attained a stable sinus rhythm within 4.0 ± 2.4 minutes, and the patients were weaned from bypass in 24.5 ± 8.0 minutes. There was no evidence of acute or chronic ischemic myocardial injury by enzymatic analysis, electrocardiography, or biopsy specimen histology. The results suggest UWS can be safely used, within currently accepted limits of donor ischemic time, to arrest and preserve human hearts for transplantation. Further studies of preservation are required to compare UWS with crystalloid cardioplegia and saline solution storage and to test the ability of UWS to prolong the period of safe donor hypothermic ischemia in clinical heart transplantation.




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