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Three Preservation Solutions for Cold Storage of Heart Allografts: A Systematic Review and Meta‐Analysis
Author(s) -
Li Yongnan,
Guo Shasha,
Liu Gang,
Yuan Yuan,
Wang Wei,
Zheng Zhe,
Hu Shengshou,
Ji Bingyang
Publication year - 2016
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12585
Subject(s) - meta analysis , blood preservation , cold storage , medicine , computer science , biology , andrology , horticulture
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 P ub M ed, E mbase, the C ochrane L ibrary, the T ransplant L ibrary, and the I nternational C linical T rials R egistry P latform. The primary outcomes were patient survival and donor heart dysfunction. The secondary outcomes were in‐hospital mortality and enzyme gene expression. The U niversity of W isconsin 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 C elsior. Hearts preserved with UW exhibited less ischemic necrosis than those preserved with C elsior ( 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 C elsior 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 C elsior solution is similar to HTK solution in donor heart preservation.