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Ann Thorac Surg 1995;59:1127-1133
© 1995 The Society of Thoracic Surgeons

Cardiac Storage With University of Wisconsin Solution and a Nucleoside-Transport Blocker

Divisions of Cardiovascular Surgery and Clinical Biochemistry, Centre for Cardiovascular Research, University of Toronto, Toronto, Ontario, Canada

Accepted for publication January 19, 1995.

Findings from previous investigations conducted at this institution and others have suggested that University of Wisconsin solution (UWS) is preferable for the prolonged hypothermic storage of hearts before transplantation. The benefit seen with UWS may in part be related to the inclusion of adenosine (5 mmol/L) in the UWS. To investigate whether further manipulations of adenosine metabolism might enhance myocardial protection, studies were initially conducted using cultured myocytes, followed by confirmatory experiments using isolated rat hearts. Cultured human ventricular myocytes (7 to 8 dishes/group) were stored for 12 hours at 0°C in unmodified UWS or UWS supplemented with increasing concentrations (1 to 100 µmol/L) of the nucleoside-transport blocker p-nitrobenzylthioinosine. The adenosine triphosphate concentrations were found to be enhanced with nucleoside-transport inhibition, with the best results achieved with the 1- and 3-µmol/L groups (control, 3.37 ± 0.41 nmol/µg DNA; UWS, 2.89 ± 1.31 nmol/µg DNA; 1 µmol/L, 5.91 ± 3.23 nmol/µg DNA; 3 µmol/L, 7.86 ± 3.45 nmol/µg DNA; p < 0.05 versus control or UWS group). Isolated rodent hearts from Sprague-Dawley rats were prepared on a Langendorff apparatus with an intraventricular balloon and subsequently stored for 8 hours at 0°C in unmodified UWS (13 hearts/group) or UWS supplemented with 1 or 3 µmol/L of p-nitrobenzylthioinosine (9 to 10 hearts/group). In separate experiments (5 to 6 hearts/group), the tissue levels of purine metabolites were monitored. The addition of the nucleoside-transport blocker was associated with an increased postischemic developed pressure (UWS, 66.2% ± 11.1%; 1 µmol/L, 75.8% ± 6.4%; 3 µmol/L, 78.3% ± 10.7%; p < 0.05 UWS versus 1- or 3-µmol/L group) while diastolic compliance was reduced after storage in all groups (p = 0.01). Coronary flow was increased in association with the nucleoside-transport blocker (UWS, 71.3% ± 16.7%; 1 µmol/L, 78.5% ± 11.0%; 3 µmol/L, 86.6% ± 13.3%; p < 0.05 UWS versus 3 µmol/L). The p-nitrobenzylthioinosine did seem to block nucleoside transport, as the hypoxanthine content was unmeasurable after perfusion in the treated groups compared with the findings in the group receiving unmodified UWS (p < 0.01).

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