EPC-K-1 IS EFFECTIVE IN LUNG PRESERVATION IN AN EX-VIVO RABBIT LUNG PERFUSION MODEL

Background. L-Ascorbic acid 2-[3,4-dihydro-2,5,7,8-tetramethyl-2- 12-t rimethyltridecyl)-2H-1-benzopyran-6yl-hydrogen phosphate] potassium sa lt (EPC-K-1) is a phosphate diester of alpha-tocopherol and ascorbic a cid. It has been reported that EPC-K-1 inhibits lipid peroxidation and phospholipase A(2). We hypothesized that EPC-K, might enhance lung pr eservation and reduce the degree of posttransplantation lung dysfuncti on. Methods. Eighteen rabbits were divided into three groups, as follo ws: group 1, no preservation (n = 6); groups 2 (n = 6) and 3 (n = 6), 24 hours of preservation at 8 degrees C. Low-potassium dextran-1% gluc ose solution was used for flushing and immersion in all groups, but EP C-K-1 (0.5 mg/L) was added to the solution used in group 3. After stor age the left lung was reperfused with autologous blood and ventilated using a membrane oxygenator in an isolated rabbit lung reperfusion mod el. The grafts used in the group 1 rabbits were perfused for 5 hours t o confirm the reliability of this model, and the grafts used in the gr oup 2 and 3 rabbits were perfused for 2 hours. Pulmonary arterial pres sure, airway pressure, blood gas analysis, and the lipid peroxide leve l of the perfusate were assessed. The lipid peroxide levels of the lun g tissue before and after storage and the wet-dry weight ratio of the perfused lung were determined in groups 2 and 3. Results. Superior gra ft function was noted in group 3 in terms of all indices. The lipid pe roxide level in the perfusate and the wet-dry weight ratio were also s uppressed in group 3. The lipid peroxide level in the lung tissue did not change during storage in either group. Conclusions. The administra tion of EPC-K-1 in the flush and preservation solution helps enhance l ung graft function and suppresses lipid peroxidation after reperfusion . (C) 1997 by The Society of Thoracic Surgeons.