Background: University of Wisconsin solution (UW) has been shown to be an e
ffective preservative for the cardiac allograft. Recently, the high potassi
um content of UW has been implicated in causing coronary endothelial damage
, allegedly contributing to development of cardiac allograft vasculopathy (
CAV) and eventually to poorer survival.
Methods: We examined our experience using UW for preservation of cardiac al
lografts between 1990 and 1994 (n = 94), and compared these to hearts prese
rved with the lower potassium-containing Stanford solution used at our cent
er between 1986 and 1990 (n = 65). indices of graft function, ischemic inju
ry, CAV incidence, CAV severity, and survival were evaluated.
Results: The 2 groups were similar in age, gender, diagnosis, donor inotrop
ic support, donor-recipient weight ratio, incidence of acute graft failure,
and cytomegalovirus seroconversion. UW-preserved hearts came from older do
nors (30.5 vs 24.1 years; p < .001), and were transplanted into more status
1 recipients (56% vs 22%, p < .001), consistent with current trends. Mean
ischemic time of UW-preserved hearts was significantly longer (184 vs 155 m
inutes, p < .005) although time required to wean from bypass was less (45.5
vs 73.8 minutes, p < .001) and there was a trend towards less inotropic re
quirement. CPK-MB release was less with UW preservation (63 vs 87 mu g/dL,
p = .001). Three years after transplantation, both groups were similar in t
he incidence of CAV (UW, 27.3%; STNF, 37.5%; p = 0.27), and also the severi
ty of CAV (p = 0.78). Deaths attributed to CAV were equal in each group (UW
, 11.4% vs STNF, 10.7%; p = 0.79). Kaplan-Meier survival analysis revealed
equivalent survival curves (p = 0.26).
Conclusions: We conclude that UW is a safe and effective myocardial preserv
ative, allowing longer ischemic times with equivalent graft function. Our d
ata suggest that when UW is used for cardiac allograft preservation, both C
AV and survival are comparable to the experience with other preservatives c
ontaining lower concentrations of potassium.