Effective 30-hour preservation of canine lungs with modified ET-Kyoto solution.
BACKGROUND
With the aim of developing a preservation solution that can preserve donor lungs reliably for a long time, we prepared a modified ET-Kyoto solution by adding N-acetylcysteine, nitroglycerin, and dibutyryl adenosine 3', 5'-cyclic phosphate to the previously reported ET-Kyoto solution, which contains trehalose, gluconate, and hydroxyethyl starch. In this study, we examined the efficacy of modified ET-Kyoto solution in 30-hour lung preservation.


METHODS
Twenty five pairs of adult mongrel dogs were divided into four groups. Donor lungs were flushed with modified ET-Kyoto solution (n = 9), with ET-Kyoto solution (n = 6), with University of Wisconsin solution group (n = 6), or with ET-Kyoto solution plus the solvents of nitroglycerin (ethanol and propylene glycol) (n = 4), then stored at 4 degrees C for 30 hours. All animals were treated with prostaglandin E1. Left lungs were transplanted and reperfused for 6 hours.


RESULTS
With respect to arterial oxygen tension, peak inspiratory pressure, and wet-to-dry lung weight ratio, modified ET-Kyoto solution was significantly superior to ET-Kyoto solution. The modified ET-Kyoto solution was significantly superior to University of Wisconsin solution with respect to survival rate, arterial oxygen tension, and wet-to-dry lung weight ratio. Ultrastructural findings supported these results.


CONCLUSIONS
These results suggest that modified ET-Kyoto solution is superior to University of Wisconsin solution for 30-hour lung preservation.
Wada
H
H
Department of Thoracic Surgery, Chest Disease Research Institute, Kyoto University, Japan.
Liu
C J
CJ
Hirata
T
T
Bando
T
T
Kosaka
S
S
D000111:Acetylcysteine / Q000494:pharmacology*; D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D003994:Bucladesine / Q000494:pharmacology*; D004285:Dogs; D004353:Drug Evaluation, Preclinical; D000431:Ethanol / Q000494:pharmacology; D005942:Gluconates / Q000494:pharmacology*; D005978:Glutathione / Q000494:pharmacology; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007328:Insulin / Q000494:pharmacology; D008168:Lung / Q000187:drug effects* / Q000502:physiology / Q000648:ultrastructure; D016040:Lung Transplantation / Q000379:methods / Q000502:physiology; D005996:Nitroglycerin / Q000494:pharmacology*; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010710:Phosphates; D019946:Propylene Glycol; D011409:Propylene Glycols / Q000494:pharmacology; D011887:Raffinose / Q000494:pharmacology; D011897:Random Allocation; D015424:Reperfusion; D012996:Solutions; D013997:Time Factors; D014199:Trehalose / Q000494:pharmacology*
C087059:ET-Kyoto solution; D005942:Gluconates; D006895:Hydroxyethyl Starch Derivatives; D007328:Insulin; D019188:Organ Preservation Solutions; D010710:Phosphates; D011409:Propylene Glycols; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; C098972:modified ET-Kyoto solution; D000431:Ethanol; D000493:Allopurinol; D003994:Bucladesine; D019946:Propylene Glycol; D014199:Trehalose; D005996:Nitroglycerin; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose; D000111:Acetylcysteine