SURFACTANT TREATMENT BEFORE REPERFUSION IMPROVES THE IMMEDIATE FUNCTION OF LUNG TRANSPLANTS IN RATS

An impaired function of alveolar surfactant can cause lung transplant dysfunction early after reperfusion. In this study it was investigated whether treatment with surfactant before reperfusion improves the imm ediate function of lung transplants and whether an improved transplant function was associated with an increase in alveolar surfactant compo nents. Left lungs with 6-h (n = 8) or prolonged 20-h ischemia (n = 10) were transplanted syngeneically in rats. In both ischemia groups half of the rung transplants were treated with surfactant just before repe rfusion. Lung function was measured during reperfusion for 1 h. Therea fter, the rats were killed and bronchoalveolar ravage was performed to measure alveolar surfactant components. We found that surfactant trea tment improved the immediate function of lung transplants in parallel with a higher amount of total surfactant phospholipids, a higher perce ntage of the heavy subtype of surfactant, a normalized percentage of p hosphatidylcholine, and a higher amount of endogenous surfactant prote in A (SP-A). We conclude that surfactant treatment before reperfusion does improve the immediate lung transplant function in rats in associa tion with an increase in alveolar surfactant components. More particul arly, the amount of (endogenous) SP-A is thought to be crucial for the efficacy of surfactant treatment after lung transplantation.