K. Takigami et al., EVALUATION OF 18-HOUR LUNG PRESERVATION WITH OXYGENATED BLOOD FOR OPTIMAL OXYGEN DELIVERY, The Annals of thoracic surgery, 66(2), 1998, pp. 362-366
Citations number
24
Categorie Soggetti
Surgery,"Cardiac & Cardiovascular System","Respiratory System
Background. Previous studies have shown that availability of oxygen du
ring lung preservation to maintain aerobic metabolism may be essential
for the optimal viability of preserved lung tissue. The purpose of th
is study was to evaluate lung preservation with oxygenated blood for o
ptimal oxygen delivery to the lung graft in a rabbit model. Methods. E
ighteen excised rabbit lungs were flushed and stored for 18 hours at 1
0 degrees C with one of the following: Euro-Collins solution (EC; n =
6), oxygenated homologous blood (OB; n = 6), or low-potassium dextran
solution (LPD; n = 6). Poststorage lung functions were evaluated with
isolated, blood-perfused lung model for 10 minutes. Results. The mean
oxygen tensions after reperfusion for the EC, OB, and LPD groups (47.0
+/- 2.8, 76.9 +/- 13.1, 96.2 +/- 10.9 mm Hg at 10 minutes, respective
ly) were significantly different throughout the perfusion period (EC <
OB < LPD, p < 0.05; EC < LPD, p < 0.01). Pulmonary artery pressure du
ring the reperfusion period in the EC group (35.8 +/- 4.4 mm Hg at 10
minutes) was higher than that in the OB and LPD groups (29.8 +/- 4.3 a
nd 22.4 +/- 2.2 mm Hg, respectively) (EC > OB, EC > LPD, p < 0.05). Ho
wever, the E-selectin level in the reperfused blood in the OB group (5
.04 +/- 0.24 ng/mL) was significantly elevated compared with that in o
ther groups (EC, 3.56 +/- 0.54; LPD, 2.92 +/- 0.35 ng/mL, p < 0.05), w
hich indicated enhanced neutrophil recruitment in the OB group. Compar
isons of thrombomodulin and endothelin among the three groups did not
reach statistical significance. Conclusions. We conclude that OB may e
nhance lung preservation as compared with EC solution, probably throug
h its enriched oxygen delivery during storage and extracellular compos
ition. However, the availability of oxygenated blood does not exceed t
hat of LPD solution because of augmented neutrophil recruitment, which
may activate neutrophil- endothelial interactions. (C) 1998 by The So
ciety of Thoracic Surgeons.