Yeh T, Hanan S A, Johnson D E, Rebeyka I M, Abd-Elfattah A S, Lee K F, Wechsler A S
Department of Surgery, Medical College of Virginia, Richmond.
Ann Thorac Surg. 1990 Jun;49(6):932-9. doi: 10.1016/0003-4975(90)90869-8.
Cardiac transplantation remains constrained by poor graft tolerance of prolonged cold ischemia. University of Wisconsin solution has remarkably extended ischemic preservation in pancreas, kidney, and liver transplantation. To assess its efficacy in cardiac preservation, modified University of Wisconsin solution flush and storage were tested against St. Thomas' cardioplegia flush and normal saline solution storage after six hours of ischemia at 0 degrees C in 46 isolated rat hearts. After ischemia, groups were compared before and after reperfusion. After ischemia but before reperfusion, University of Wisconsin solution hearts had significantly less tissue water (3.8%), superior tissue sodium, potassium, calcium, and magnesium profiles, and elevated adenosine and inosine levels, and tended toward better histological preservation. After reperfusion, University of Wisconsin solution more effectively preserved left ventricular compliance (75% versus 35% of baseline), developed pressure (71% versus 45% of baseline), histological integrity, and tissue potassium and calcium profiles than St. Thomas' solution. The University of Wisconsin solution provided superior preservation of systolic and diastolic ventricular function, tissue histology, tissue water, and tissue electrolytes than did St. Thomas' cardioplegia and normal saline solution storage in this experimental model, and might result in improved graft tolerance of ischemia in clinical cardiac transplantation.
心脏移植仍然受到延长冷缺血时间后移植物耐受性差的限制。威斯康星大学溶液在胰腺、肾脏和肝脏移植中显著延长了缺血保存时间。为了评估其在心脏保存中的效果，在46个离体大鼠心脏于0℃缺血6小时后，对改良的威斯康星大学溶液冲洗和保存与圣托马斯心脏停搏液冲洗及生理盐水保存进行了测试。缺血后，对再灌注前后的各组进行比较。在缺血后但再灌注前，威斯康星大学溶液组的心脏组织含水量显著更低（3.8%），组织钠、钾、钙和镁水平更优，腺苷和肌苷水平升高，并且在组织学保存方面有更好的趋势。再灌注后，与圣托马斯溶液相比，威斯康星大学溶液更有效地保存了左心室顺应性（分别为基线的75%和35%）、舒张末压（分别为基线的71%和45%）、组织学完整性以及组织钾和钙水平。在该实验模型中，威斯康星大学溶液在收缩和舒张心室功能、组织组织学、组织含水量和组织电解质的保存方面优于圣托马斯心脏停搏液和生理盐水保存，并且可能会改善临床心脏移植中缺血移植物的耐受性。
