A COMPARISON OF THE UNIVERSITY-OF-WISCONSIN SOLUTION AND THE MODIFIEDKAWAKAMI SOLUTION FOR INITIAL FLUSH AND CORONARY PERFUSION IN LONG-TERM CANINE HEART PRESERVATION

Background. We compared two different solutions, the University of Wis consin (UW) solution (intracellular-like) and the modified Kawakami (m K) solution (extracellular-like), for initial flush of coronary vascul ar beds before simple storage and following coronary perfusion, Method s. After a right thoracotomy in the 4th intercostal space, the donor h eart was isolated by Ligating the azygos vein and venae cavae, and cro ss-clamping the aorta, Cardiac arrest was then obtained with a cold GI K solution. Following initial flush of coronary vascular beds, the don or heart was resected, stored utilizing a combination of simple immers ion and coronary perfusion, and then transplanted. A total of 48 mongr el dogs was divided into three groups each using different solutions f or the initial flush of coronary vascular beds and for coronary perfus ion. In group I(n=10) the UW solution was used for both initial flush and coronary perfusion. In group II (n=7) the mK solution was used for both initial flush and coronary perfusion, and in group III (n=7) the UW solution was used for initial flush and the mK solution for corona ry perfusion. Intracellular high-energy phosphate was surveyed by P-31 -nuclear magnetic resonance spectroscopy. Results. After 12-hour simpl e immersion and I-hour coronary perfusion, phosphocreatine and adenosi ne triphosphate were significantly (p<0.05) higher in group III than i n groups I and II. The high-energy phosphate levels of the graft tissu e were better in groups I and III than in group II. Orthotopic transpl antation was then performed using 10 preserved grafts in group I and s even preserved grafts of group III. After transplantation, left ventri cular (LV) pressure of group I animals recovered to 82.3% and group II I recovered to 95.8% of the control values. LV dp/dt of group I and LU animals recovered to 76.5% and 96.7% of the control values respective ly. Conclusions. The UW solution, which is acceptable for both initial flush and simple storage, is not suitable for continuous coronary per fusion even for a short period due to its high viscosity. A combinatio n of the UW solution both for initial flush and the following cold sim ple immersion and the mK solution for continuous coronary perfusion is appropriate for long-term preservation of the canine heart.