Skip to main content

High-risk heart grafts: effective preservation with Celsior solution


Celsior solution has already proved effective in heart graft preservation because it reduces myocardial edema, prevents free radical damage, and limits calcium overload. The aim of this study was to evaluate the effectiveness of Celsior solution as myocardial protection in high-risk transplantation. Hospital charts and follow-up data of 200 consecutive heart recipients (162 males, 38 females, mean age 47.4 ± 12.6 years) were reviewed. Patients were divided into two groups: group A (73 patients) included recipients of high-risk grafts (at least two of the following: age >45; female sex; high preretrieval inotropic support, viz. dobutamine or dopamine >10 µg/kg per minute and/or infusion of norepinephrine regardless of its dosage; size mismatch >20%; ischemia time >180 min) and group B (127 patients) included recipients of standard grafts. Quality of preservation was assessed through enzyme release, echocardiographic evaluation, the need for inotropic support or pacemaker, and histology of biopsy samples. Hospital and 1-year mortality were also evaluated. Comparisons between the two groups were made through univariate analysis. Study groups proved homogeneous as to recipient age, pretransplant cardiomyopathy, status at transplantation, mean panel reactive antibodies, and redo cardiac surgery. Hospital mortality was 8% (11% vs 6.3%, P = 0.18) while 1-year mortality reached 12% (15.1% vs 10.2%, P = 0.6) without significant difference between groups. Graft performance as described by the need for inotropic support and/or pacemaker as well as echocardiography (left and right ventricular ejection fraction) proved comparable. There were no significant differences as to histology findings and patterns of enzyme release. Celsior provides optimal myocardial preservation in both standard and high-risk procedures. Such advances help to enhance donor pool expansion.

This is a preview of subscription content, access via your institution.


  1. JH Southard (1999) Organ preservation GB Klintmalm MF Levy (Eds) Organ procurement and preservation Landes Bioscience Austin 63–79

    Google Scholar 

  2. A Singh KJ Lee CY Lee RD Golfarb MF Tsan (1989) ArticleTitleRelation between myocardial glutathione content and extent of ischemia reperfusion injury Circulation 80 1790–1804

    Google Scholar 

  3. A Astier M Paul (1989) ArticleTitleInstability of reduced glutathione in commercial Belzer cold storage solution Lancet 2 556–557 Occurrence Handle1:STN:280:BiaA28znsFY%3D Occurrence Handle2570247

    CAS  PubMed  Google Scholar 

  4. MS Jahania JA Sanchez P Narayan RD Lasley RM Mentzer (1999) ArticleTitleHeart preservation for transplantation: principles and strategies Ann Thorac Surg 68 1983–1987 Occurrence Handle10.1016/S0003-4975(99)01028-0 Occurrence Handle1:STN:280:DC%2BD3c%2FkvFyisw%3D%3D Occurrence Handle10585116

    Article  CAS  PubMed  Google Scholar 

  5. SC Stoica DK Satchithananda J Dunning SR Large (2001) ArticleTitleTwo-decade analysis of cardiac storage for transplantation Eur J Cardiothorac Surg 20 792–798 Occurrence Handle10.1016/S1010-7940(01)00847-8 Occurrence Handle1:STN:280:DC%2BD3MrivVWmtA%3D%3D Occurrence Handle11574227

    Article  CAS  PubMed  Google Scholar 

  6. TL Demmy JS Biddle LE Bennett JT Walls RA Schmaltz JJ Curtis (1997) ArticleTitleOrgan preservation solutions in heart transplantation – patterns of usage and related survival Transplantation 63 262–269 Occurrence Handle1:STN:280:ByiC2s3isVA%3D Occurrence Handle9020328

    CAS  PubMed  Google Scholar 

  7. D Wheeldon L Sharples J Wallwork T English (1992) ArticleTitleDonor heart preservation survey J Heart Lung Transplant 11 986–993 Occurrence Handle1:STN:280:ByyD2c7osVA%3D Occurrence Handle1420249

    CAS  PubMed  Google Scholar 

  8. P Menaschè F Praider J Peynet (1991) ArticleTitleLimitation of free radical injury by reduced gluthatione: an effective means of improving the recovery of heart transplant Transplant Proc 23 2440–2442 Occurrence Handle1926422

    PubMed  Google Scholar 

  9. P Menasche JL Termignon F Pradier C Grousset C Mouas G Alberici M Weiss A Piwnica G Bloch (1994) ArticleTitleExperimental evaluation of Celsior, a new heart preservation solution Eur J Thorac Cardiovasc Surg 8 207–213 Occurrence Handle1:STN:280:ByuA3cvmtFM%3D

    CAS  Google Scholar 

  10. J Ackermann W Gross M Mory M Schaefer MM Gebhard (2002) ArticleTitleCelsior versus Custodiol: early postischemic recovery after cardioplegia and ischemia at 5°C Ann Thorac Surg 74 522–529

    Google Scholar 

  11. JD Vega JL Ochsner V Jeevanandam DC McGiffin KR McCurry RM Mentzer SuffixJr JC Stringham RN Pierson Suffix3rd OH Frazier AH Menkis ED Staples DL Modry RW Emery W Piccione SuffixJr M Carrier PJ Hendry S Aziz S Furukawa SM Pham (2001) ArticleTitleA multicenter, randomized, controlled trial of Celsior for flush and hypothermic storage of cardiac allograft Ann Thorac Surg 71 1442–1447 Occurrence Handle10.1016/S0003-4975(01)02458-4 Occurrence Handle1:STN:280:DC%2BD3MzhtVemtg%3D%3D Occurrence Handle11383780

    Article  CAS  PubMed  Google Scholar 

  12. JP Remadi O Baron JC Roussel O Al Habash M Treilhaud P Despins D Duveau J Michaud (2002) ArticleTitleMyocardial preservation using Celsior solution in cardiac transplantation: early results and 5-year follow-up of a multicenter prospective study of 70 cardiac transplantations Ann Thorac Surg 73 1495–1499 Occurrence Handle10.1016/S0003-4975(02)03424-0 Occurrence Handle12022539

    Article  PubMed  Google Scholar 

  13. Bennett LE, Keck BM, Hertz MI, Trulock EP, Taylor DO (2001) Worldwide thoracic organ transplantation: a report from the UNOS/ISHLT international registry for thoracic organ transplantation. Clin Transpl 25–40

  14. J Mohara Y Morishita T Takahashi K Oshima T Yamagishi I Takeyoshi K Matsumoto (1999) ArticleTitleA comparative study of Celsior and University of Wisconsin solutions based on 12-hr preservation followed by transplantation in canine models J Heart Lung Transplant 18 1202–1210 Occurrence Handle1:STN:280:DC%2BD3c%2FnslKhtA%3D%3D Occurrence Handle10612379

    CAS  PubMed  Google Scholar 

  15. HM Kauffman LE Bennett MA McBride MD Eleison (1997) ArticleTitleThe Expanded donor Transplant Rev 11 165–190 Occurrence Handle10.1016/S0955-470X(97)80037-7

    Article  Google Scholar 

  16. U Livi A Milano U Bortolotti R Casula M Zenati D Casarotto (1994) ArticleTitleResults of heart transplantation by extending recipient selection criteria J Cardiovasc Surg 35 377–382 Occurrence Handle1:STN:280:ByqD1cfitlI%3D

    CAS  Google Scholar 

  17. GY Ott RE Herschberger RR Ratkovec D Norman JD Hosenpud A Cobanoglu (1994) ArticleTitleCardiac allografts from high-risk donors: excellent clinical results Ann Thorac Surg 57 76–81 Occurrence Handle1:STN:280:ByuC3cjgslU%3D Occurrence Handle8279923

    CAS  PubMed  Google Scholar 

  18. DR Wheeldon CD Potter M Jonas J Wallwork SR Large (1993) ArticleTitleTransplantation of “unsuitable” organs? Transplant Proc 25 3104–3105 Occurrence Handle1:STN:280:ByuD1M%2FnslE%3D Occurrence Handle8266471

    CAS  PubMed  Google Scholar 

  19. LS De Santo C Marra M De Feo C Amarelli G Romano M Cotrufo (2002) ArticleTitleThe impact of gender on heart transplantation outcomes: a single center experience Ital Heart J 3 419–423 Occurrence Handle12189971

    PubMed  Google Scholar 

  20. TW Prendergast S Furukawa J Beyer BJ Browne HJ Eisen V Jeevanandam (1998) ArticleTitleThe role of gender in heart transplantation Ann Thorac Surg 65 88–94 Occurrence Handle10.1016/S0003-4975(97)01105-3 Occurrence Handle1:STN:280:DyaK1c7hsFKgtA%3D%3D Occurrence Handle9456101

    Article  CAS  PubMed  Google Scholar 

  21. AC Anyawu CA Rogers AJ Murday (1999) ArticleTitleShould recipient risk be a factor in choosing recipients for suboptimal donor hearts: a multi-institutional study Transplant Proc 31 1399–1400

    Google Scholar 

  22. SM Wildhirt M Weis C Schulze N Conrad G Rieder G Enders K Ihnken W von Scheidt B Reichart (2000) ArticleTitleEffects of Celsior and University of Wisconsin preservation solutions on hemodynamics and endothelial function after cardiac transplantation in humans: a single-center, prospective, randomised trial Transplant Int 13 203–211

    Google Scholar 

  23. GM Wieselthaler O Chevtchik R Konetschny R Moidl R Mallinger P Mares A Griessmacher M Grimm E Wolner G Laufer (1999) ArticleTitleImproved graft function using a new myocardial preservation solution: Celsior. Preliminary data from a prospective study Transplant Proc 31 2067–2068 Occurrence Handle10.1016/S0041-1345(99)00264-X Occurrence Handle1:STN:280:DyaK1MzosV2isQ%3D%3D Occurrence Handle10455971

    Article  CAS  PubMed  Google Scholar 

  24. M Garlicki J Kolcz P Rudzinski B Kapelak J Sadowski S Wojcik E Pietrzyk W Frasik J Drukala A Dziatkowiak (1999) ArticleTitleMyocardial protection for transplantation Transplant Proc 31 2079–2083 Occurrence Handle10.1016/S0041-1345(99)00269-9 Occurrence Handle1:STN:280:DyaK1MzosV2iug%3D%3D Occurrence Handle10455976

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Luca Salvatore De Santo.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

De Santo, L., Amarelli, C., Romano, G. et al. High-risk heart grafts: effective preservation with Celsior solution. Heart Vessels 21, 89–94 (2006).

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI:

Key words

  • Heart transplantation
  • Organ preservation
  • Cardioplegic solution
  • Postoperative outcome