Evaluation of highly buffered low-calcium solution for long-term preservation of the heart

Comparison of University of Wisconsin and University of Pittsburgh solutions for heart transplantation

“…These findings support the conclusion of the study that showed the superiority of UW solution to Stanford or Collins solutions using the isolated canine heart model for 12 h at 4 "C [26]. UP solution is a highly buffered preservation solution containing a high concentration of histidine [18]. In the report that showed the superiority of UP solution to UW solution, the authors used the Langendorff heart model with an asanguineous perfusate to assess cardiac function after reperfusion following prolonged cold ischemia [18].…”

“…UP solution is a highly buffered preservation solution containing a high concentration of histidine [18]. In the report that showed the superiority of UP solution to UW solution, the authors used the Langendorff heart model with an asanguineous perfusate to assess cardiac function after reperfusion following prolonged cold ischemia [18]. UP solution was developed based on the theory that by inhibiting intracellular acidosis, promoting anaerobic glycolysis positively, and removing detrimental end-products chemically during ischemia with histidine, high-energy phosphate compounds, which are indispensable for the maintenance of the integrity of the myocardium, can be produced effectively, leading to an extension of preservation time.…”

“…To obtain maximum graft survival as well as to determine the optimal temperature for both solutions with prolonged organ preservation, several other groups of hearts were preserved at different temperatures (21 "C and 4°C) for 6 and 12 h, respectively, in the two solutions. Six hearts were preserved in UP solution at 21 "C for 6 h since superior preservation of high-energy phosphates has been shown with moderate hypothermia (13 "C-21 "C) [18]; one of the six grafts survived for more than 7 days after transplantation (data not shown). Then, several other groups of hearts were preserved in both UW and UP solutions at 4°C for 6 and 12 h, respectively; 100% of the grafts survived longer than 7 days (data not shown) until sacrifice.…”

“…Also, the superiority of UW solution to Euro-Collins (EC) [15], St. Thomas Hospital Cardioplegic (ST) [ll], and Collins' M (CM) [28] solutions in heart preservation has been assessed. However, recently, Ohkado et al [18] reported a new preservation solution for the heart containing a high concentration of histidine and lidocaine named University of Pittsburgh (UP) solution. They demonstrated the superiority of the solution to UW solution for heart preservation with the Langendorff heart model [lo].…”

Buffering excess hydrogen ions increases ischemic tolerance in hypertrophied myocardium

“…However, there is no general agreement and none became popular in the marketplace. del Nido cardioplegia solution was originally introduced as a myocardial tissue preservation solution, 1 as was Bretschneider histidine-tryptophan-ketoglutarate (HTK) crystalloid solution. Both have been used for pediatric and adult cardiac surgery.…”