title: Low-potassium solution for lung preservation in the setting of high-flow reperfusion.
abstract: BACKGROUND
  We previously demonstrated that standard preservation using Euro-Collins solution impairs lung function in the setting of high-flow reperfusion because of potassium-induced vasoconstriction. Preservation strategies for single-lung transplantation are an important factor in patients with pulmonary hypertension. This study investigates the hypothesis that low-potassium preservation solution will improve function of lungs subjected to high-flow reperfusion.
  
  
  METHODS
  Twenty-one New Zealand white rabbit lungs were harvested and studied on an isolated, blood-perfused model of lung function after 4 hours of cold ischemia at 4 degrees C. Control lungs were preserved with 50 mL/kg of cold saline solution flush (group I). Experimental lungs were preserved with low-potassium solution (group II) or Euro-Collins solution (group III) at similar temperatures and volumes.
  
  
  RESULTS
  The pulmonary arteriovenous oxygen gradient at the end of the 30-minute high-flow reperfusion period was significantly higher in group II compared with group III (121.3 +/- 19.2 mm Hg versus 31.1 +/- 4.2 mm Hg; p < 0.001). The pulmonary vascular resistance was significantly lower in group II than in group III (46.3 +/- 1.8 x 10(3) dynes x s x cm(-5) versus 79.8 +/- 8.4 x 10(3) dynes x s x cm(-5); p < 0.01. The percent decrease in dynamic airway compliance in group III was significantly greater than in group I and II (-51.0% +/- 13.3% versus -10.2% +/- 3.4% and -11.2% +/- 2.8%, respectively; p < 0.001). Similarly, the wet to dry ratio of the lungs in group III was significantly greater than in groups I and II (13.9 +/- 2.3 versus 5.9 +/- 0.2 and 6.0 +/- 0.4, respectively; p < 0.001).
  
  
  CONCLUSIONS
  These data demonstrate that a low-potassium preservation solution yields improved lung function after high-flow reperfusion in an ex vivo rabbit lung model. Lung preservation should be aimed at the clinical setting.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
authors.forename: N F
authors.initials: NF
authors.lastname: DeLima
authors.forename: O A
authors.initials: OA
authors.lastname: Binns
authors.forename: S A
authors.initials: SA
authors.lastname: Buchanan
authors.forename: J T
authors.initials: JT
authors.lastname: Cope
authors.forename: M C
authors.initials: MC
authors.lastname: Mauney
authors.forename: K S
authors.initials: KS
authors.lastname: Shockey
authors.forename: C G
authors.initials: CG
authors.lastname: Tribble
authors.forename: I L
authors.initials: IL
authors.lastname: Kron
mesh_terms: D000818:Animals; D006982:Hypertonic Solutions; D008168:Lung / Q000502:physiology; D009926:Organ Preservation / Q000379:methods; D011188:Potassium; D011817:Rabbits; D015424:Reperfusion; D012996:Solutions
chemical_list: C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D012996:Solutions; D011188:Potassium