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Ann Thorac Surg 1997;63:388-394
© 1997 The Society of Thoracic Surgeons

Original Article: Cardiovascular

Effects of Butanedione Monoxime and Temperature on Prolonged Cardiac Storage

Ji Zhang, MD, Robert D. Furukawa, BSc, Stephen E. Fremes, MD, Donald A. G. Mickle, MD, Richard D. Weisel, MD

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

Accepted for publication August 3, 1996.

Background. The optimal temperature for cardiac allograft storage remains controversial. We conjectured that supplementation of the potent cardioprotective agent 2,3-butanedione monoxime with calcium may improve allograft storage and make the precise storage temperature less critical.

Methods. Hearts were harvested from Sprague-Dawley rats (250 to 350 g), mounted on a Langendorff apparatus, and instrumented with an intraventricular balloon. Hearts were flushed and stored with either unmodified University of Wisconsin solution (UWS) or UWS supplemented with 10 mmol/L of 2,3-butanedione monoxime and calcium 0.1 mmol/L (BDM). Hearts were then subjected to 12 hours of storage at one of five temperatures (0°, 4°, 8°, 12°, or 16°C) in a complete 2 x 5 factorial design (n = 6/group). Data are reported either as a percentage of the prestorage results or as an absolute value (mean ± standard deviation).

Results. Recovery of developed pressure (p < 0.0001), coronary flow (p < 0.0001), and diastolic volume (p < 0.001) were significantly enhanced, whereas creatine kinase (p < 0.0001) and lactate dehydrogenase release (p < 0.0001) were reduced in the BDM versus the UWS groups. In both the BDM and UWS storage groups, recovery was better at temperatures of 8°C or less than at 12°C or more. The single preferred temperature was 4°C, significantly better than 0°C with unmodified UWS, while similar to 0° and 8°C with BDM. Adenine nucleotide values were decreased equally in the BDM and UWS hearts, but preservation was enhanced at 0°C compared with all warmer temperatures.

Conclusions. We conclude that 4°C is the preferred temperature for prolonged cardiac storage with UWS and that the inclusion of 2,3-butanedione monoxime with calcium 0.1 mmol/L markedly enhances recovery for storage temperatures of 8°C or less.






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