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J Thorac Cardiovasc Surg 1994;107:1356-1363
© 1994 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

The role of adenosine in extended myocardial preservation with the University of Wisconsin solution

Madison, Wis.

Supported by a grant to Dr. Lasley from the American Heart Association, Wisconsin Affiliate, and to Dr. Mentzer (RO1 HL-34579) from the National Institutes of Health.

Received for publication May 25, 1993. Accepted for publication Sept. 8, 1993. Address for reprints: Robert D. Lasley, PhD, Department of Surgery, University of Wisconsin School of Medicine, H4-383 Clinical Sciences Center, 600 Highland Ave., Madison, WI 53792.

Abstract

The purpose of this study was to determine the role that adenosine plays in enhanced myocardial preservation during cold storage with the University of Wisconsin solution. Hearts from adult rabbits were flushed with University of Wisconsin solution with or without adenosine and stored at 4° C for 24 hours. Interstitial fluid purine levels during the period of cold storage were estimated with cardiac microdialysis probes. In a second series of experiments hearts were flushed with University of Wisconsin solution with or without adenosine or St. Thomas' Hospital cardioplegic solution and stored for 18 hours (4° C). Functional recovery was assessed by reperfusing the hearts on a Langendorff apparatus (100 cm H₂O) for 45 minutes with Krebs-Henseleit buffer. During cold storage dialysate adenosine concentrations in hearts flushed with University of Wisconsin solution were 20- to 40-fold greater than adenosine levels in hearts flushed without adenosine. After 45 minutes of reperfusion hearts preserved with University of Wisconsin solution exhibited a rate-pressure product of 11,098 ± 576 mm Hg/min, significantly greater than that for hearts flushed with University of Wisconsin solution minus adenosine (8106 ± 780 mm Hg/min) and St. Thomas' Hospital solution (7317 ± 768 mm Hg/min). These results suggest that adenosine plays a major role in enhanced myocardial preservation with the University of Wisconsin solution, possibly by maintaining elevated interstitial fluid adenosine levels during the period of cold storage. (J THORACCARDIOVASCSURG1994;107:1356-63)

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