An original heart preservation solution (Celsior) has been developed, the formulation of which has been designed to fulfil two major objectives:(1) to combine the general principles of hypothermic organ preservationwith those specific for the myocardium, and (2) to offer the possibility ofbeingused not only as a storage medium but also as a perfusion fluidduring initial donor heart arrest, poststorage graft reimplantation andearly reperfusion. The major principles addressed by the Celsiorformulation include (1) prevention of cell swelling (by mannitol andlactobionate), (2) prevention of by the Celsior formulation include (1)prevention of cell swelling (by mannitol and lactobionate), (2) preventionof oxygen-derived free radical injury (by reduced glutathione, histidineand mannitol), and (3)prevention of contracture by enhancement of energyproduction (glutamate) and limitation of calcium overload (high magnesiumcontent, slight degree of acidosis). Two experimental preparations wereused: The isolated isovolumic buffer-perfused rat heart model and theheterotopic rabbit heart transplantationmodel. In isolated heartexperiments, hearts were arrested with and stored in Celsior for 5 h at 4degrees C and subsequently reperfused for 1 h. A similar protocol was usedin the transplantation experiments except that the total ischemic time wasapproximately 1 1/2 h longer (corresponding to 6 h of storage followed bythe 25 additional minutes of cold ischemia required for graftimplantation.(ABSTRACT TRUNCATED AT 250 WORDS). © Springer-Verlag 1994.