LUNG PRESERVATION WITH EURO-COLLINS, UNIVERSITY-OF-WISCONSIN, WALLWORK, AND LOW-POTASSIUM-DEXTRAN SOLUTIONS

Using isolated rat lungs, we compared prevention of ischemia-reperfusi on injury provided by flushing the lungs with modified Euro-Collins so lution (EC), University of Wisconsin solution (UW), low-potassium-dext ran solution (LPD), or Wallwork solution (WA). After 4 hours' and 6 ho urs' cold ischemia, reperfusion injury was assessed on the basis of ch anges in filtration coefficients (K-fc) and pressure-now curves, chara cterized by the slope of the curves (incremental resistance) and the e xtrapolation of this slope to zero now (pulmonary pressure intercept [ Ppi]). After 4 hours, K-fc and Ppi were higher with EC than with UW, L PD, and WA, and the incremental resistance was higher with EC and UW. After 6 hours, K-fc and incremental resistance Ppi were higher with LP D than with WA. Because ischemia-reperfusion injury is associated with decreased endothelial synthesis of prostacyclin and nitric oxide, we tested whether the addition of prostacyclin or the nitric oxide precur sor L-arginine to WA would improve preservation. The K-fc and Ppi were lower with both treatments. In conclusion, ischemia-reperfusion injur y was best prevented by using WA. The favorable effect of prostacyclin or L-arginine emphasizes the role played by endothelial dysfunction i n ischemia-reperfusion injury.