Document Detail


Comparison of UW versus HTK solution for myocardial protection in heart transplantation.
MedLine Citation:
PMID:  11271286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to evaluate the protective effect of University of Wisconsin (UW) solution in heart transplantation, a retrospective comparative study with histidine-tryptophane-ketoglutarate (HTK) solution was initiated. In group I, we included 160 patients with HTK preservation, while group II consisted of 50 patients who had their transplant protected with UW solution. All patients received standard quadruple drug therapy for immunosuppression. The average ischaemic time of the donor hearts in group I was 142+/-44 min, ranging from 83 to 235 min. Acute immediate perioperative graft failure occurred in six cases (3.8%). Statistical analysis including the chi-square test, revealed a significant increase in the incidence of acute perioperative graft failure when compared with duration of ischaemic time (P < 0.01). Within the first 30 postoperative days, 24 patients died (15% early mortality). The same statistical correlation was evident between the incidence of early mortality and duration of graft ischaemic time. The 30-day and 6-month survival rates were 81% and 78%, respectively. The average ischemic time of the donor hearts in group II was 193+/-50 min ranging from 100 to 360 min, which was significantly longer in comparison with the group I (P < 0.05). Acute perioperative graft failure occurred once (2%); the patient was retransplanted successfully. Five patients died within the first 30 postoperative days (10% early mortality). There was no correlation between length of ischaemic time and incidence of acute graft failure or early mortality. The 30-day and 6-month survival rates were 90% and 88%, respectively and, thus, better when compared with group I. In both groups similar results were achieved with regard to postoperative NYHA status of the patients and incidence of cardiac arrhythmias. Myocardial preservation with HTK solution showed satisfying results as long as the ischaemic time did not exceed 4 h. The early functional results achieved with UW graft protection were excellent, even with ischaemic times longer than 4 h and not depending on lenght of ischaemic period.
Authors:
H Reichenspurner; C Russ; F Wagner; P Uberfuhr; G Nollert; C Weinhold; B Reichart
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  7 Suppl 1     ISSN:  0934-0874     ISO Abbreviation:  Transpl. Int.     Publication Date:  1994  
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  S481-4     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, University Hospital Grosshadern, München, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adenosine*
Allopurinol*
Arrhythmias, Cardiac / epidemiology
Chi-Square Distribution
Female
Glucose*
Glutathione*
Graft Survival*
Heart*
Heart Transplantation / mortality,  physiology*,  statistics & numerical data
Humans
Insulin*
Ischemia
Male
Mannitol*
Middle Aged
Organ Preservation Solutions*
Postoperative Complications / epidemiology
Postoperative Period
Potassium Chloride*
Procaine*
Raffinose*
Reoperation
Retrospective Studies
Survival Rate
Time Factors
Treatment Failure
Chemical
Reg. No./Substance:
0/Bretschneider cardioplegic solution; 0/Organ Preservation Solutions; 0/University of Wisconsin-lactobionate solution; 11061-68-0/Insulin; 315-30-0/Allopurinol; 50-99-7/Glucose; 512-69-6/Raffinose; 58-61-7/Adenosine; 59-46-1/Procaine; 69-65-8/Mannitol; 70-18-8/Glutathione; 7447-40-7/Potassium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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