A LACTOBIONATE-BASED EXTRACELLULAR-TYPE SOLUTION FOR DONOR HEART PRESERVATION

The University of Wisconsin solution, which contains the impermeant la ctobionate and has an intracellular-type electrolyte composition, has been shown to improve donor heart preservation. Because a deleterious effect of the intracellular-type solutions has been reported, we evalu ated a new lactobionate-based extracellular-type solution, by comparin g it with University of Wisconsin solution and a crystalloid cardiople gic solution in 45 rabbit hearts. Hearts were arrested by infusion of these solutions and immersed in the same solution (lactobionate-based extracellular-type solution, University of Wisconsin solution) or in t he lactated Ringer's solution (crystalloid cardioplegic solution) for 6 hours at 4-degrees-C. A Langendorff circuit was used for reperfusion . Left ventricular compliance was better preserved with both lactobion ate-based solutions than with the crystalloid cardioplegic solution. A denosine triphosphate was best preserved with the lactobionate-based e xtracellular-type solution after arrest and after reperfusion, whereas reperfusion arrhythmias were less marked with the University of Wisco nsin solution. These results suggest that lactobionate plays an import ant role in the preservation of ventricular compliance and that the la ctobionate-based extracellular-type solution is preferable for adenosi ne triphosphate preservation. Further study will be required to assess the factors predisposing to reperfusion arrhythmias.