Influence of long-term preservation with endobronchially administered perfluorodecalin on pulmonary graft function

Background. Experimental studies demonstrated a suppression of oxygen-deriv ed free radicals, reduced adhesion of activated neutrophils on the endothel ium and an increase of de novo synthesis of surfactant during liquid ventil ation with perflurocarbon. The purpose of this study was to assess the pulm onary graft function after preservation with endobronchially administered p erfluorocarbon as an alternative to flush perfusion. Methods. Native bred p igs underwent orthotopic left lung transplantation. Donor lungs were flushe d in situ with either a low-potassium dextran solution (LPD, n=6) or a perf luorochemical was administered endobronchially (PFC, n=6) and were then sto red after removal for 18 hr at 4%C. Pulmonary graft function was assessed a fter reperfusion for 5 hr by measuring pulmonary gas exchange and hemodynam ics during isolated ventilation and perfusion. Tissue specimens were taken for analysis of morphology and wet/dry ratio. All values were compared to a sham-operated group (n=6). Results. Pulmonary gas exchange of the graft re vealed reduced paO2, values and elevated paCO2, values in the PFC group thr oughout the observation period as compared with the LPD group and sham grou p. Endothelial alterations and fibrin exudate in the PFC group were signifi cantly more pronounced. Lungs in the LPD group showed functional and morpho logical recovery close to sham group. Conclusions. Long-term preservation w ith endobronchially administered perfuorocarbon is possible. Impaired pulmo nary graft function and pronounced morphological alterations indicate an ag gravation of the ischemic reperfusion injury after lung transplantation com pared to LPD preserved lungs.