Ledingham S J, Katayama O, Lachno D R, Yacoub M
Department of Cardiothoracic Surgery, National Heart and Lung Institute, London, England.
Circulation. 1990 Nov;82(5 Suppl):IV351-8.
The University of Wisconsin solution differs from other types of solutions used for organ preservation because it contains high-energy phosphate precursors (adenosine and phosphate), impermeants (lactobionate and raffinose), an oncotic agent (pentafraction), and antioxidants (allopurinol and glutathione). These components have the potential to enhance the preservation of ATP, reduce intracellular and extracellular edema, and attenuate free-radical-mediated injury. The University of Wisconsin solution has been demonstrated to enhance and extend the preservation of the liver, pancreas, and kidney, but its potential role in the heart remains unproven. We have evaluated the University of Wisconsin solution (Du Pont) by comparing it with the St. Thomas' Hospital cardioplegic solutions No. 1 and No. 2 (Plegisol), which are used in Europe and the United States for routine cardiac surgery and transplantation. For each solution, 10 isolated working rat hearts were arrested by 10 ml of the solution (at 4 degrees C) and then maintained immersed in the same solution for 4 hours at 4 degrees C. Mean recovery of functional indexes (expressed as a percentage of their preischemic control values) after use of the University of Wisconsin solution were as follows: peak aortic pressure, 90.6 +/- 1.0; dP/dt, 71.5 +/- 5.5; aortic flow, 81.6 +/- 4.7; coronary flow, 87.5 +/- 3.5; and cardiac output, 82.6 +/- 3.5. In contrast, the mean recoveries after St. Thomas' Hospital solution No. 1 were as follows: peak aortic pressure, 82.8 +/- 1.3; dP/dt, 49.7 +/- 3.0; aortic flow, 58.4 +/- 5.3; coronary flow, 79.6 +/- 5.9; and cardiac output, 63.0 +/- 4.9. In contrast still, mean recoveries after St. Thomas' Hospital solution No. 2 were as follows: peak aortic pressure, 83.1 +/- 1.2; dP/dt, 40.7 +/- 6.1; aortic flow, 37.0 +/- 5.1; coronary flow, 65.8 +/- 3.6; and cardiac output, 43.1 +/- 5.6. The recovery of all indexes were significantly superior (p less than 0.005) after preservation with University of Wisconsin solution compared with either of the St. Thomas' Hospital solutions.(ABSTRACT TRUNCATED AT 250 WORDS)
威斯康星大学溶液与其他用于器官保存的溶液不同，因为它含有高能磷酸前体（腺苷和磷酸盐）、非渗透剂（乳糖酸盐和棉子糖）、一种胶体渗透压剂（羟乙基淀粉）和抗氧化剂（别嘌呤醇和谷胱甘肽）。这些成分有可能增强三磷酸腺苷（ATP）的保存，减少细胞内和细胞外水肿，并减轻自由基介导的损伤。威斯康星大学溶液已被证明能增强和延长肝脏、胰腺和肾脏的保存，但它在心脏方面的潜在作用仍未得到证实。我们通过将威斯康星大学溶液（杜邦公司生产）与圣托马斯医院心脏停搏液1号和2号（普列吉索尔）进行比较来评估它，这两种溶液在欧洲和美国用于常规心脏手术和移植。对于每种溶液，用10毫升该溶液（在4摄氏度）使10个离体工作的大鼠心脏停搏，然后将其浸泡在相同溶液中于4摄氏度下保存4小时。使用威斯康星大学溶液后功能指标的平均恢复情况（以缺血前对照值的百分比表示）如下：主动脉峰值压力，90.6±1.0；dp/dt，71.5±5.5；主动脉流量，81.6±4.7；冠状动脉流量，87.5±3.5；心输出量，82.6±3.5。相比之下，圣托马斯医院1号溶液后的平均恢复情况如下：主动脉峰值压力，82.8±1.3；dp/dt，49.7±3.0；主动脉流量，58.4±5.3；冠状动脉流量，79.6±5.9；心输出量，63.0±4.9。同样相比之下，圣托马斯医院2号溶液后的平均恢复情况如下：主动脉峰值压力，83.1±1.2；dp/dt，40.7±6.1；主动脉流量，37.0±5.1；冠状动脉流量，65.8±3.6；心输出量，43.1±5.6。与圣托马斯医院的任何一种溶液相比，用威斯康星大学溶液保存后所有指标的恢复情况均显著更好（p＜0.005）。（摘要截短于250字）
