Eliminating the strong pulmonary vasoconstriction caused by Euro-Collins solution.
Single-flush perfusion with Euro-Collins solution (ECS), after pretreatment with prostaglandin E1 or prostacyclin, is at most centers the standard procedure for preservation of lungs for transplantation. In a previous study, we showed that the high potassium content of ECS causes strong pulmonary vasoconstriction at temperatures higher than 20 degrees C. In the present study, five drugs used as pretreatment and added to the perfusate were compared for their ability to counteract ECS-induced constriction of porcine pulmonary arteries: papaverine reduced the vasoconstrictive effect by 92% +/- 4%; nifedipine, by 62% +/- 6%; the thromboxane A2 receptor antagonist daltroban, by 15% +/- 4%; and prostaglandin E1, by 12% +/- 4%. On the other hand, prostacyclin not only failed to reduce ECS-induced vasoconstriction but at the highest concentration tested, enhanced it by 37% +/- 7%. The combination of papaverine (10(-4) mol/L) and nifedipine (10(-6.5) mol/L) was the only pretreatment to abolish ECS-induced vasoconstriction; moreover, it has no adverse effect on endothelial function. Neither prostaglandin E1 nor prostacyclin effectively counteracts ECS-induced vasoconstriction, though they may have other beneficial effects.
Kimblad
P O
PO
Department of Cardiothoracic Surgery, University Hospital, Lund, Sweden.
Steen
S
S
D000527:Alprostadil / Q000378:metabolism / Q000494:pharmacology; D000818:Animals; D003251:Constriction, Pathologic / Q000139:chemically induced / Q000517:prevention & control; D004338:Drug Combinations; D004347:Drug Interactions; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism; D011464:Epoprostenol / Q000378:metabolism / Q000494:pharmacology; D006982:Hypertonic Solutions / Q000009:adverse effects* / Q000494:pharmacology; D008954:Models, Biological; D009543:Nifedipine / Q000378:metabolism / Q000494:pharmacology; D010208:Papaverine / Q000378:metabolism / Q000494:pharmacology; D010648:Phenylacetates / Q000378:metabolism / Q000494:pharmacology; D011651:Pulmonary Artery / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000378:metabolism / Q000494:pharmacology; D013552:Swine; D013928:Thromboxane A2 / Q000378:metabolism / Q000494:pharmacology; D013931:Thromboxanes / Q000037:antagonists & inhibitors; D014661:Vasoconstriction / Q000187:drug effects; D014665:Vasodilator Agents / Q000378:metabolism / Q000494:pharmacology*
D004338:Drug Combinations; C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D010648:Phenylacetates; D013449:Sulfonamides; D013931:Thromboxanes; D014665:Vasodilator Agents; D013928:Thromboxane A2; D010208:Papaverine; D011464:Epoprostenol; D000527:Alprostadil; D009543:Nifedipine; C051762:daltroban