Is the UW solution adequate as an initial flush solution for heart procurement? a comparative study of celsior and UW solutions

Abstract

The University of Wisconsin (UW) solution has been widely utilized in the process of organ preservation. Its high potassium content and high viscosity however, have been reported to cause vasoconstriction or endothelial damage during heart procurement. We previously reported that the Celsior solution with its high buffer capacity, low potassium content, and low viscosity was equivalent to or superior to the UW solution for cardiac preservation. In this study, myocardial temperature during the washout of coronary vascular beds and myocardial energy metabolism soon after the excision of hearts were evaluated by focusing on the initial flush effect of both solutions. Adult mongrel dogs weighing 9.5 to 13.5 kg were used. Following cardiac arrest using cardioplegia, the heart was cooled with ice slush and coronary vascular beds were washed out with a 4°C UW solution (UW group; n = 5) or Celsior solution (Celsior group; n = 5) at a pressure of 80 cm H2O. During the period of initial washout using 200 ml of solution, both the myocardial temperature and the time required to reach myocardial temperature of 15°C, were noted. The time required to complete the initial washout was also measured. Phosphocreatine (PCr), ß-adenosine triphosphate (ATP) and inorganic phosphate (Pi) levels were measured by using ³¹P-nuclear magnetic resonance spectroscopy soon after the excision of hearts. PCr/Pi and ß-ATP/Pi values were identified as indicators of myocardial high-energy phosphate levels. The Celsior group tended to require a shorter time to reach a myocardial temperature of 15°C compared with the UW group. The total initial washout time was significantly shorter in the Celsior group than in the UW group. PCr/Pi and ß-ATP/Pi values were significantly higher in the Celsior group than in the UW group. The Celsior solution appears to have significant advantages when used as an initial flush solution compared with the UW solution in heart procurement.