Aprotinin improves pulmonary function during reperfusion in an isolated lung model

Background. We hypothesized that the use of aprotinin would ameliorate the reperfusion injury observed after lung transplantation because of a reducti on in the inflammatory response. Methods. We used an isolated, whole blood-perfused, ventilated rabbit lung model to study the effects of aprotinin during reperfusion. The control ani mals (group A, n = 8) underwent lung harvest after pulmonary arterial prost aglandin E-1 injection and Euro-Collins preservation flush before saline st orage for 18 hours at 4 degreesC. The experimental groups received either a low dose (3,000 KIU/mL; group B, n = 8) or a high dose (10,000 KIU/mL; gro up C, n = 8) of aprotinin added to the pulmonary flush before storage. Each lung was reperfused at 37 degreesC at a rate of 60 mL/min. Results. The arterial partial pressure of oxygen values of group B (low-dos e aprotinin) were significantly higher than those of group A (control) afte r 10 minutes of reperfusion (69.19 +/- 5.69 mm Hg versus 264.30 +/- 48.59 m m Hg, respectively, p = 0.001). Similar results were recorded at 20 and at 30 minutes of reperfusion. Similarly, after 10 minutes of reperfusion, the differences between groups A and C were 69.19 +/- 5.69 mm Hg versus 235.91 +/- 28.63 mm Hg, respectively (p = 0.001). Conclusions. The addition of aprotinin to the Euro-Collins pulmonary flush significantly improves arterial oxygenation in the early reperfusion period . The enhanced oxygenation suggests that aprotinin may offer protection aga inst early reperfusion injury. (Ann Thorac Surg 2000;70:1671-4) (C) 2000 by The Society of Thoracic Surgeons.