Three Preservation Solutions for Cold Storage of Heart Allografts: A Systematic Review and Meta‐Analysis |
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| Authors: | Yongnan Li Shasha Guo Gang Liu Yuan Yuan Wei Wang Zhe Zheng Shengshou Hu Bingyang Ji |
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| Affiliation: | 1. Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China;2. Department of Cardiac Surgery, Lanzhou University Second Hospital, Lanzhou, China;3. Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China |
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| Abstract: | Organ preservation solution has been designed to attenuate the detrimental effects during the ischemic period. The aim of this study was to systematically evaluate the evidence comparing preservation solutions for heart preservation. Studies were searched in PubMed, Embase, the Cochrane Library, the Transplant Library, and the International Clinical Trials Registry Platform. The primary outcomes were patient survival and donor heart dysfunction. The secondary outcomes were in‐hospital mortality and enzyme gene expression. The University of Wisconsin solution (UW) was associated with a significantly improved survival at 30 days and 90 days (hazard ratio = 1.16, 95% confidence interval [CI] = 1.11–1.22, P < 0.00001; risk difference [RD] = 0.03, 95% CI = 0.01–0.05, P = 0.002), compared with Celsior. Hearts preserved with UW exhibited less ischemic necrosis than those preserved with Celsior (RD = ?0.07, 95% CI = ?0.08 to 0.05, P < 0.00001). UW was associated with better survival compared with histidine–tryptophan–ketoglutarate solution (HTK). There was no statistical difference in donor heart dysfunction and in‐hospital mortality outcomes when comparing HTK with Celsior solution. During static cold storage preservation, this study suggests that UW solution has better clinical outcomes for heart transplantation compared with the other two organ preservation solutions. Besides, the protective effect of Celsior solution is similar to HTK solution in donor heart preservation. |
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| Keywords: | Heart transplantation Organ preservation Organ preservation solution Systematic review |
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