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Ann Thorac Surg 1996;61:576-584
© 1996 The Society of Thoracic Surgeons

Original Article: Cardiovascular

Comparison of UW Solution and St. Thomas' Solution in the Rat: Importance of Potassium Concentration

Franklin L. Rosenfeldt, FRACS, Robert A. J. Conyers, FRCPA, Paula Jablonski, PhD, Lesley Langley, BApplSci, Stephen M. Richards, PhD, Gregory Self, MB,BS, Vernon Marshall, FRACS

Baker Medical Research Institute, Alfred Hospital, and Department of Surgery, Monash Medical Centre, Melbourne, Victoria, Australia

Accepted for publication September 18, 1995.

Background. University of Wisconsin solution (UW) is in limited clinical use for heart transplantation, but there are doubts about its efficacy and concerns about the effect of its high K+ concentration on endothelium. St. Thomas' solution with or without aspartate is widely used and is of proven efficacy.

Methods. Using a modified (starch-free) variant of UW (MUW) we studied: (1) recovery of function with UW compared with aspartate-containing St. Thomas' solution; (2) effect of elevation of K+ in St. Thomas' solution to the level in UW; and (3) effect of reduction of K+ in UW and addition of Ca2+ or aspartate. Isolated rat hearts underwent 7 hours of arrest at 1°C using MUW with or without 20 mmol/L aspartate or using aspartate-containing St. Thomas' solution.

Results. Functional recovery with MUW (51.8% ± 2.5%) was superior to that with aspartate-containing St. Thomas' solution (37.1% ± 4.3%; p < 0.01). Addition of aspartate to MUW had no effect. During 6 hours of arrest, lowering the K+ in MUW from 125 mmol/L to 20 mmol/L reduced functional recovery from 59.9% ± 4.2% to 42.3% ± 4.3% (p < 0.01). The addition of 1 mmol/L Ca2+ had no effect. Elevation of K+ in St. Thomas' solution produced more rapid arrest but no improvement in recovery.

Conclusions. The protective effect of starch-free UW is greater (+13%) than that of aspartate-enriched St. Thomas' solution. Reduction of K+ in UW to lessen possible deleterious effects would decrease its protective effect by about 30% to a level comparable with that of St. Thomas' solution.




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