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Ann Thorac Surg 2001;71:403-404
© 2001 The Society of Thoracic Surgeons

Correspondence

Long-term preservation of isolated heart

Ahmet Özyazicioglu, MDa, Azman Ates, MDa, Ibrahim Yekeler, MDa

a Department of Cardiovascular Surgery, Atatürk University School of Medicine, 25240 Erzurum, Turkey

e-mail: violinahmet{at}hotmail.com

To the Editor

We read with interest the article by Ou and associates in the November 1999 issue of The Annals of Thoracic Surgery [1]. In this study, Ou and coworkers show that the levels of adenosine triphosphate (ATP) in St. Thomas’ solution (ST)-treated and University of Wisconsin solution (UW)-treated hearts at 25°C were lower than for corresponding groups at 4°C (p < 0.01). The ATP concentration was not significantly different in UW and ST hearts at 4°C. After storage at 25°C, the level was lower in the UW group than in the ST group (p < 0.05). Consequently, UW at higher temperatures is not favorable for storage of the heart.

We have previously published a partly similar study [2]. A lot of experimental studies have claimed that UW is significantly superior to ST in long-term preservation under hypothermic conditions. However, other studies point out that UW is inferior to ST [3]. There is also a plethora of research comparing the results of adding various pharmacological agents into the solutions. Besides these discussions, we have performed this study in order to improve the long- and short-term storage quality of the UW and ST solutions.

In our study, four different solutions (UW, ST, and their modifications by pentoxyfillin [Ptx]) are investigated with regard to adenine nucleotide catabolism in the short- and long-term storage of cardiac explant. The four solutions are compared in the following groups: 1) ST vs UW; 2) ST vs ST + Ptx; 3) UW vs UW + Ptx; and 4) ST + Ptx vs UW + Ptx.

Cobays of the same gender and age were heparinized and their hearts were excised under anesthesia. The hearts were perfused and transmural myocardial biopsies were taken after 10 minutes and 1, 3, 6, and 12 hours. Energy Charge Ratio (ECR) was calculated on the basis of adenosine triphosphate (ATP), adenosine diphosphate (ADP), and adenosine monophosphate (AMP) values. Consequently, in the long-term preservation of isolated cobay heart under hypothermic conditions, UW has been found to be significantly superior to ST (p < 0.05). The addition of Ptx to ST displays a preserving effect on ATP levels in the tissue after 1, 3, and 6 hours. This result can be explained by the finding that Ptx is the inhibitor of 5' nucleotidase; it decreases the effect of cytokine production and increases the effect of prostaglandin synthesis. However, UW solution and Ptx do not appear to be a suitable combination for preserving ATP contents under hypothermic conditions.

References

  1. Ou R., Gavin J.B., Esmore D.S., et al. Increased temperature reduces the protective effect of University of Wisconsin solution in the heart. Ann Thorac Surg 1999;68:1628-1635.[Abstract/Free Full Text]
  2. Özyazicioglu A., Ceviz M., Yekeler I., et al. Long-term preservation of isolated cobay heart with the solution of University of Wisconsin, St. Thomas’ II and their modifications. AÜTD 1996;28:220-225.
  3. Choong Y.S., Gavin J.B. Functional recovery of hearts after cardioplegia and storage in University of Wisconsin and in St. Thomas’ Hospital solutions. J Heart Lung Transplant 1991;10:537-546.[Medline]




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