TY - JOUR
T1 - Both blood and crystalloid-based extracellular solutions are superior to intracellular solutions for lung preservation
AU - Binns, O. A.R.
AU - DeLima, N. F.
AU - Buchanan, S. A.
AU - Cope, J. T.
AU - King, R. C.
AU - Marek, C. A.
AU - Shockey, K. S.
AU - Tribble, C. G.
AU - Kron, I. L.
AU - Kaiser, L. R.
AU - Patterson, G. A.
AU - Keshavjee, S.
N1 - Funding Information:
Supported by the National Institutes of Health under RO1 grant No. HL 48242 and National Research Service Award fellowship No. F32HL09115-01A1. Additional support from CNPq–Conselho Nacional de Desenvolvimento Cientifico e Tecnologico, Brazil.
PY - 1996
Y1 - 1996
N2 - Objective: Lung transplantation remains limited by donor organ ischemic time, inadequate graff preservation, and reperfusion injury. We evaluated long preservation with use of an extracellular solution, with or without the addition of blood, as compared with preservation with the intracellular Euro- Collins solution. Methods: With use of an isolated, whole blood perfused/ventilated rabbit lung model, we studied three groups of animals. Lungs were flushed with Euro-Collins, low-potassium dextran, or 20% blood- low-potassium dextran solution. Longs were harvested en bloc, stored inflated at 4° C for 18 hours, and then reperfused at 60 ml/min with whole blood. Continuous measurements of pulmonary artery pressure, pulmonary vascular resistance, and dynamic airway compliance were obtained. Fresh, nonrecirculated venous blond was used to determine the single-pass pulmonary venous-arterial oxygen gradient. Results: Lungs preserved with Euro-Collins solution demonstrated elevated pulmonary artery pressure and pulmonary vascular resistance when compared with those preserved with low-potassium dextran and 20% blood-low-potassium dextran solutions (pulmonary artery pressure: 40.8 ± 2.2 mm Hg vs 28.9 ± 2.4 mm Hg and 28.3 ± 1.5 mm Hg, respectively, p < 0.001; pulmonary vascular resistance: 46.0 ± 3.1 x 103 dynes · sec · cm-5 vs 29.0 ± 4.2 x 103 dynes · sec · cm-5 and 28.8 ± 2.3 x 103 dynes · sec · cm-5, respectively, p < 0.001). Euro-Collins solution-preserved lungs demonstrated a significant drop in compliance when compared with those preserved with low-potassium dextran and 20% blood-low- potassium dextran (-21.9% ± 4.7% vs 1.8% ± 3.3% and 1.4% ± 6.2%, respectively; p = 0.002). Oxygenation was improved with low-potassium dextran and 20% blood-low-potassium dextran solutions as compared with that with Euro-Collins solution (296.3 ± 54.6 mm Hg and 290.2 ± 66.4 mm Hg, respectively, vs 37.2 ± 4.6 mm Hg; p = 0.001). Conclusions: Extracellular solutions provided superior preservation of pulmonary function in this rabbit lung model of ischemia-reperfusion. However, the addition of blood does not confer any demonstrable advantage over low-potassium dextran solution alone with use of an 18-hour period of cold ischemia.
AB - Objective: Lung transplantation remains limited by donor organ ischemic time, inadequate graff preservation, and reperfusion injury. We evaluated long preservation with use of an extracellular solution, with or without the addition of blood, as compared with preservation with the intracellular Euro- Collins solution. Methods: With use of an isolated, whole blood perfused/ventilated rabbit lung model, we studied three groups of animals. Lungs were flushed with Euro-Collins, low-potassium dextran, or 20% blood- low-potassium dextran solution. Longs were harvested en bloc, stored inflated at 4° C for 18 hours, and then reperfused at 60 ml/min with whole blood. Continuous measurements of pulmonary artery pressure, pulmonary vascular resistance, and dynamic airway compliance were obtained. Fresh, nonrecirculated venous blond was used to determine the single-pass pulmonary venous-arterial oxygen gradient. Results: Lungs preserved with Euro-Collins solution demonstrated elevated pulmonary artery pressure and pulmonary vascular resistance when compared with those preserved with low-potassium dextran and 20% blood-low-potassium dextran solutions (pulmonary artery pressure: 40.8 ± 2.2 mm Hg vs 28.9 ± 2.4 mm Hg and 28.3 ± 1.5 mm Hg, respectively, p < 0.001; pulmonary vascular resistance: 46.0 ± 3.1 x 103 dynes · sec · cm-5 vs 29.0 ± 4.2 x 103 dynes · sec · cm-5 and 28.8 ± 2.3 x 103 dynes · sec · cm-5, respectively, p < 0.001). Euro-Collins solution-preserved lungs demonstrated a significant drop in compliance when compared with those preserved with low-potassium dextran and 20% blood-low- potassium dextran (-21.9% ± 4.7% vs 1.8% ± 3.3% and 1.4% ± 6.2%, respectively; p = 0.002). Oxygenation was improved with low-potassium dextran and 20% blood-low-potassium dextran solutions as compared with that with Euro-Collins solution (296.3 ± 54.6 mm Hg and 290.2 ± 66.4 mm Hg, respectively, vs 37.2 ± 4.6 mm Hg; p = 0.001). Conclusions: Extracellular solutions provided superior preservation of pulmonary function in this rabbit lung model of ischemia-reperfusion. However, the addition of blood does not confer any demonstrable advantage over low-potassium dextran solution alone with use of an 18-hour period of cold ischemia.
UR - http://www.scopus.com/inward/record.url?scp=0030460790&partnerID=8YFLogxK
U2 - 10.1016/S0022-5223(96)70010-7
DO - 10.1016/S0022-5223(96)70010-7
M3 - Article
C2 - 8975843
AN - SCOPUS:0030460790
SN - 0022-5223
VL - 112
SP - 1515
EP - 1521
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -