Effect of Celsior and University of Wisconsin solutions on myocardial metabolism and function after warm ischemia

Background. Optimal preservation of donor hearts remains a significant conc ern during transplantation. Organ shortage led to an increase in the use of damaged hearts. Methods. To study the effect of preservation solutions on recovery of myoca rdial metabolism and function after warm ischemia, 10 dogs underwent 30 min utes of warm global ischemia under cardiopulmonary bypass. The animals were then administered 1 liter of Celsior (5 dogs), an extracellular crystalloi d solution or 1 liter of University of Wisconsin solution (5 dogs), cooled at 4 degrees C, followed by 60 minutes of cold preservation and 30 minutes of warm blood reperfusion. Interstitial myocardial pH and pO(2) changes wer e measured, The left ventricle dP/dt was measured before and after the isch emic episode, as where creatine kinase, troponine T and lactate serum level s. Results. Tissue pH averaged 6.9+/-0.1, 6.2+/-0.1, 6.7+/-0.1 and 6.8+/-0.1 b efore and after warm ischemia, following the 60 minutes of cold preservatio n and the reperfusion period in animals treated with the Celsior solution, compared to 6.8+/-0.1, 6.4+/-0.1, 7+/-0.1 and 6.8+/-0.2 respectively in dog s treated with the University of Wisconsin solution (p<0.05), Oxygen tensio n in the myocardium averaged 36+/-8 mmHg before warm Ischemia and 59+/-31 m mHg after in animals that received Celsior compared to 30+/-10 mmHg and 49/-7 mmHg in dogs treated with University of Wisconsin (p>0.05), Global myoc ardial function decreased significantly following reperfusion compared to b aseline in both groups of animals. The serum levels of creatine kinase, tro ponine T and lactate Increased significantly during the experiment although there was no significant difference between the 2 groups. Conclusion. Both preservation solutions (Celsior and University of Wisconsi n) resulted in suboptimal recovery of myocardial function and metabolism wh en administered after a period of warm Ischemia. Strategies to improve reco very of damaged donor hearts remain to be appropriately defined.