EVALUATION OF HYPOTHERMIC HEART PRESERVATION WITH UNIVERSITY-OF-WISCONSIN SOLUTION IN HETEROTOPICALLY AND ORTHOTOPICALLY TRANSPLANTED CANINE HEARTS

In simple cold storage of the heart, 4 hours has been proved to be a c linically safe ischemic time. The University of Wisconsin solution has been reported to extend cold ischemic time in preservation of the liv er, kidney, and pancreas. The purpose of this study is to clarify the safe cold ischemic time in heart preservation with University of Wisco nsin solution experimentally in heterotopically and orthotopically tra nsplanted canine hearts. In heterotopic heart transplantation, 120 min utes after reperfusion, maximum slope of the left ventricular end-syst olic pressure-volume relationship was recovered to 94% +/- 13% in the 4-hour simple cold preservation group with GIK solution and 104% +/- 1 1% in the 8-hour simple cold preservation group with University of Wis consin solution but was not recovered in the 8-hour simple cold preser vation with GIK solution and 16-hour simple cold preservation with Uni versity of Wisconsin solution groups. One hundred twenty minutes after reperfusion, myocardial tissue blood flow measured by laser Doppler f lowmeter was recovered to 90% +/- 19% after 4 hours with simple cold p reservation with GIK solution and 98% +/- 9% after 8 hours with simple cold preservation with University of Wisconsin solution but was not r ecovered after 8 hours with simple cold preservation with GIK solution and 16 hours with simple cold preservation with University of Wiscons in solution. One hundred twenty minutes after reperfusion, serum creat ine phosphokinase levels (international units per liter) after 4 hours with simple cold preservation with GIK solution and 8 hours with simp le cold preservation with University of Wisconsin solution were lower than those after 8 hours with simple cold preservation with GIK soluti on and 16 hours with simple cold preservation with University of Wisco nsin solution. One hundred twenty minutes after reperfusion, mitochond ria in electron microscopic study were normally preserved after 4 hour s with simple cold preservation with GIK solution and 8 hours with sim ple cold preservation with University of Wisconsin solution. In orthot opic heart transplantation, 120 minutes after reperfusion, cardiac out put, left ventricular maximum rate of pressure rise, maximum slope of the left ventricular end-systolic pressure-volume relationship, and ex ternal work/pressure volume area efficiency recovered by dobutamine (1 0 mug/kg/min) administration after 4 hours with simple cold preservati on with GIK solution and 8 hours with simple cold preservation with Un iversity of Wisconsin solution. These results suggest that use of Univ ersity of Wisconsin solution for heart preservation extends the safe c old ischemic time up to at least 8 hours but not up to 16 hours. In si mple cold storage of the heart, 4 hours has been proved to be a clinic ally safe ischemic time.