IMPROVED LUNG-FUNCTION BY UROKINASE INFUSION IN CANINE LUNG TRANSPLANTATION USING NON-HEART-BEATING DONORS

We evaluated the effect of urokinase on pulmonary microthrombi formati on of the donor lung using a canine cadaver left lung allotransplantat ion model. Donor animals were sacrificed with an intravenous injection of potassium chloride without heparinization and were divided into th ree groups. In group 1 (n = 6), cadavers were left at room temperature for 1 hour, and lung retrieval was then performed after flushing the lung block with low potassium-dextran-glucose solution. Donor lungs we re stored for 3 hours at 8 degrees C. In group 2 (n = 6), donor lungs were treated as in group 1 except that the cadavers were left at room temperature for 2 hours instead of 1 hour before lung retrieval. In gr oup 3 (n = 6), donor lungs were treated as in group 2 except that high -dose urokinase (120,000 IU) was injected into the main pulmonary arte ry after hushing with low-potassium-dextrose-glucose solution. In all groups after left lung transplantation, the right pulmonary artery was ligated, and recipient animals were followed up far 6 hours after rep erfusion. The fibrin degradation product level in the donor lung tissu e was also measured, Ail recipient animals in group I survived the 6-h our observation period with excellent gas exchange and stable hemodyna mics. Group 3 had significantly better gas exchange than group 2 and s imilar cardiopulmonary function as group 1. The fibrin degradation pro duct level in the donor lungs before transplantation was significantly higher in group 3 than in group 2. This study supports the theory tha t urokinase improves lung function after cadaver lung transplantation by fibrinolytic action an pulmonary microthrombi formation in the cada ver donor lungs.