COMPARISON OF EUROCOLLINS AND UNIVERSITY-OF-WISCONSIN SOLUTION IN SINGLE FLUSH PRESERVATION OF THE ISCHEMIC-REPERFUSED LUNG - AN IN-VIVO RABBIT MODEL

The standard preservation technique in lung transplantation is cold si ngle pulmonary artery flush (PAF) with Eurocollins solution (ECS). We compared ECS with University of Wisconsin (UFY) solution, with and wit hout added indomethacin, in single PAF preservation in an in vivo rabb it model of warm ischemia-reperfusion lung injury. Six groups of four New Zealand white rabbits each underwent isolation and hilar stripping of the left lung. In the four experimental groups, the left lung was flushed with (15 ml/kg) of cold ECS or UW solution, with or without ad ded indomethacin, before warm ischemia for 120 minutes and before repe rfusion for 60 minutes. The remaining two groups were the nonischemic and the ischemic ''no flush'' controls. Transcapillary flux of (99m)Te chnitium-labeled albumin and electron microscopy were used to demonstr ate lung injury. Pulmonary vascular resistance (PVR) and thromboxane B -2 (TXB(2)) concentrations were measured. There was a significant rise in PVR after ischemia/reperfusion in the ischemic control group (54.7 +/-13.9 to 117.8+/-20.7 mm Hg/L . min(-1), P<0.05). The net rise in PV R after ischemia-reperfusion was significantly smaller in the two grou ps in which indomethacin was added (16.8+/-17.5 and 4.5+/-10.6 mm Hg/L . min(-1) for UW and ECS, respectively) compared with the ischemic co ntrol (63.1+/-24.6 mm Hg/L . min(-1), P<0.05). Postreperfusion TXB(2) levels tended to be lower in the nonischemic control group and in the indomethacin-flush groups. We conclude that the increase in PVR produc ed by unilateral ischemia-reperfusion lung injury in this model was im proved by single PAF perfusion. There was no significant difference be tween UW solution and ECS in this regard. The addition of indomethacin to the flush solution was associated with lower PVRs as well as morph ologic improvement by electron microscopy. These findings may indicate a prominent role for the provision of PG synthesis inhibition during preservation for lung transplantation.