Oar. Binns et al., BOTH BLOOD AND CRYSTALLOID-BASED EXTRACELLULAR SOLUTIONS ARE SUPERIORTO INTRACELLULAR SOLUTIONS FOR LUNG PRESERVATION, Journal of thoracic and cardiovascular surgery, 112(6), 1996, pp. 1515-1521
Objective: Lung transplantation remains limited by donor organ ischemi
c time, inadequate graft preservation, and reperfusion injury, We eval
uated lung 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, Lungs were harv
ested en bloc, stored inflated at 4 degrees C for 18 hours, and then r
eperfused at 60 ml/min,vith whole blood, Continuous measurements of pu
lmonary artery pressure, pulmonary vascular resistance, and dynamic ai
rway compliance were obtained, Fresh, nonrecirculated venous blood was
used to determine the single-pass pulmonary venous-arterial oxygen gr
adient, Results: Lungs preserved with Euro-Collins solution demonstrat
ed elevated pulmonary artery pressure and pulmonary vascular resistanc
e 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, respect
ively, p < 0.001; pulmonary vascular resistance: 46.0 +/- 3.1 x 10(3)
dynes . sec . cm(-5) vs 29.0 +/- 4.2 x 10(3) dynes . sec . cm(-5) and
28.8 +/- 2.3 x 10(3) dynes . sec . cm(-5), respectively, p < 0.001), E
uro-Collins solution-preserved lungs demonstrated a significant drop i
n compliance when compared,vith those preserved with low-potassium dex
tran 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 impr
oved with low-potassium dextran and 20% blood-low-potassium dextran so
lutions 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 p
reservation of pulmonary function in this rabbit lung model of ischemi
a-reperfusion. However, the addition of blood does not confer any demo
nstrable advantage over low-potassium dextran solution alone with use
of an 18-hour period of cold ischemia.