Dr. Jones et al., REDUCED ISCHEMIA-REPERFUSION INJURY WITH ISOPROTERENOL IN NON-HEART-BEATING DONOR LUNGS, The Journal of surgical research, 69(2), 1997, pp. 385-392
Transplantation of lungs retrieved from non-heart-beating donors could
expand the donor pool. Recent studies suggest that the ischemia-reper
fusion injury (IRI) to the lung can be attenuated by increasing intrac
ellular cAMP concentrations. The purpose of this study was to determin
e the effect of IRI on capillary permeability, as measured by K-fc, in
lungs retrieved from nan-heart-beating donors and reperfused with or
without isoproterenol (iso), Using an in situ isolated perfused lung m
odel, lungs were retrieved from non-heart-beating donor rats ventilate
d with O-2 or not at varying intervals after death. The lungs were rep
erfused with or without iso (10 mu M). K-fc, lung viability, and pulmo
nary hemodynamics were measured, and tissue levels of adenine nucleoti
des and cAMP were measured by HPLC. Iso-reperfusion decreased K-fc sig
nificantly (P < 0.05) compared to non-iso-reperfused groups at all pos
tmortem ischemic times, irrespective of preharvest ventilation status.
Pulmonary arterial pressures and resistances increased and venous res
istances decreased with iso-reperfusion. Total adenine nucleotide (TAN
) levels correlated with K-fc in non-iso-reperfused (r = 0.65) and iso
-perfused (r = 0.84) lungs. cAMP levels increased significantly with i
so-reperfusion. cAMP levels correlated with K-fc (r = 0.87) in iso-rep
erfused lungs. Iso-reperfusion of lungs retrieved from non-heart-beati
ng donor rats results in decreased capillary permeability and increase
d lung tissue cAMP levels, Pharmacologic augmentation of tissue TAN an
d cAMP levels may further ameliorate the increased capillary permeabil
ity seen in lungs retrieved from non-heart-beating donors. (C) 1997 Ac
ademic Press.