University of Wisconsin solution versus crystalloid cardioplegia for human donor heart preservation: A randomized blinded prospective clinical trial

V. Jeevanandam, M. L. Barr, J. S. Auteri, Juan Sanchez, J. Fong, F. A. Schenkel, C. C. Marboe, R. E. Michler, C. R. Smith, E. A. Rose

Research output: Contribution to journalArticle

Abstract

We have previously shown the safety and efficacy of University of Wisconsin solution for hypothermic preservation of the human donor heart in a pilot group of 16 transplant recipients. The present study is a randomized clinical trial comparing University of Wisconsin solution to conventional preservation using crystalloid cardioplegia and saline storage within a 4- hour limit of ischemia. Heart transplant recipients (n = 42) were randomized into two groups: those receiving hearts preserved by University of Wisconsin solution, the UWS group (n = 22), and those receiving hearts preserved in the conventional manner, the CCS group (n = 20). Recipient age, gender, heart disease, and preoperative inotropic support and donor age, gender, and mean ischemic time in hours (UWS 2 hours 36 minutes, range 1 hour 36 minutes to 2 hours 53 minutes; CCS 2 hours 20 minutes, range 1 hour 20 minutes to 2 hours 44 minutes; p = not significant) were similar. Significant differences observed between the two groups included (1) mean time (minutes) from reperfusion to achieve a stable rhythm, (2) need for intraoperative defibrillations, (3) need for transient cardiac pacing, and (4) integrated postoperative creatinine kinase and aspartate aminotransferase release over 48 hours. There was no difference in postoperative electrocardiogram, endomyocardial biopsy, or hemodynamics. One UWS patient died of sepsis and another of a ruptured cerebral aneurysm. UWS is safe for donor organ arrest and preservation despite high viscosity and potassium concentration. When compared with CCS hearts, hearts preserved in UWS regained electrical activity more rapidly and had better myocardial protection as demonstrated by enzymatic analysis. Further investigation is required to determine the effects of UWS preservation on long-term survival, to determine the prevalence of rejection and graft atherosclerosis, and to test the ability of UWS to extend donor ischemic time in human cardiac transplantation.

Original languageEnglish (US)
Pages (from-to)194-199
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume103
Issue number2
StatePublished - 1992
Externally publishedYes

Fingerprint

Induced Heart Arrest
Tissue Donors
Clinical Trials
Organ Preservation
Ruptured Aneurysm
Graft Rejection
Intracranial Aneurysm
Heart Transplantation
Aspartate Aminotransferases
Viscosity
Reperfusion
crystalloid solutions
Heart Diseases
Creatinine
Sepsis
Atherosclerosis
Potassium
Electrocardiography
Phosphotransferases
Ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

University of Wisconsin solution versus crystalloid cardioplegia for human donor heart preservation : A randomized blinded prospective clinical trial. / Jeevanandam, V.; Barr, M. L.; Auteri, J. S.; Sanchez, Juan; Fong, J.; Schenkel, F. A.; Marboe, C. C.; Michler, R. E.; Smith, C. R.; Rose, E. A.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 103, No. 2, 1992, p. 194-199.

Research output: Contribution to journalArticle

Jeevanandam, V, Barr, ML, Auteri, JS, Sanchez, J, Fong, J, Schenkel, FA, Marboe, CC, Michler, RE, Smith, CR & Rose, EA 1992, 'University of Wisconsin solution versus crystalloid cardioplegia for human donor heart preservation: A randomized blinded prospective clinical trial', Journal of Thoracic and Cardiovascular Surgery, vol. 103, no. 2, pp. 194-199.
Jeevanandam, V. ; Barr, M. L. ; Auteri, J. S. ; Sanchez, Juan ; Fong, J. ; Schenkel, F. A. ; Marboe, C. C. ; Michler, R. E. ; Smith, C. R. ; Rose, E. A. / University of Wisconsin solution versus crystalloid cardioplegia for human donor heart preservation : A randomized blinded prospective clinical trial. In: Journal of Thoracic and Cardiovascular Surgery. 1992 ; Vol. 103, No. 2. pp. 194-199.
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