L-arginine and pentoxifylline attenuate endothelial dysfunction after lung reperfusion injury in the rabbit. The Paris-Sud University Lung Transplant Group.
BACKGROUND
Among the factors involved in the early complications of lung transplantation is the ischemia-reperfusion syndrome related to a warm reperfusion in ischemic lungs.


METHODS
Using an isolated rabbit lung preparation perfused with whole blood, we studied the effects of cold ischemia followed by a warm reperfusion on pulmonary vascular responses to reproduce experimentally the conditions encountered during lung transplantation.


RESULTS
Pulmonary vascular responses to acetylcholine were rapidly altered by warm ischemia (relaxation of 7% versus 60% in controls). Conversely, relaxation was maintained even after a prolonged cold ischemic storage (maximal relaxation of 57% at 48 hours). Warm reperfusion in ischemic lungs induced major alteration of endothelium-dependent relaxation (maximal relaxation of 13% at 4 hours). The addition of L-arginine or pentoxifylline during reperfusion prevented the pulmonary endothelial alteration resulting from warm reperfusion.


CONCLUSIONS
These data suggest that treatments aimed at maintaining intact functional endothelium reduce ischemia-reperfusion injury in transplanted lungs.
Normandin
L
L
Laboratoire de Chirurgie Expérimentale, Unité de Recherche Associée 1159, Paris-Sud University, Le Plessis Robinson, France.
Hervé
P
P
Brink
C
C
Chapelier
A R
AR
Dartevelle
P G
PG
Mazmanian
G M
GM
D000109:Acetylcholine / Q000494:pharmacology; D000818:Animals; D001120:Arginine / Q000627:therapeutic use*; D001769:Blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D003080:Cold Temperature; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000293:injuries; D007511:Ischemia / Q000503:physiopathology; D008168:Lung / Q000098:blood supply* / Q000187:drug effects; D055370:Lung Injury; D016040:Lung Transplantation / Q000009:adverse effects*; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000293:injuries; D010431:Pentoxifylline / Q000627:therapeutic use*; D011651:Pulmonary Artery / Q000187:drug effects / Q000503:physiopathology; D011817:Rabbits; D015427:Reperfusion Injury / Q000517:prevention & control*; D015203:Reproducibility of Results; D014661:Vasoconstriction / Q000187:drug effects; D014664:Vasodilation / Q000187:drug effects
D001120:Arginine; D000109:Acetylcholine; D010431:Pentoxifylline