A newly developed solution enhances thirty-hour preservation in a canine lung transplantation model.
Ischemia and reperfusion cause the production of oxygen free radicals. These damage grafts or disrupt normal vascular homeostatic mechanisms, with a parallel reduction in endothelial nitric oxide and adenosine 3',5'-cyclic monophosphate levels. We hypothesized that lung preservation failure may be related to these events. To improve lung preservation, we prepared a new ET-Kyoto solution, which contains N-acetylcysteine (a radical scavenger), nitroglycerin (to elevate the nitric oxide level), and dibutyryl adenosine 3',5'-cyclic monophosphate (to elevate the adenosine 3',5'-cyclic monophosphate level) and examined its efficacy in a canine single-lung transplantation model. Lungs were flushed with new ET-Kyoto solution (group I, n = 9), basal ET-Kyoto solution (group II, n = 6), basal ET-Kyoto solution plus ethanol and propylene glycol (solvents of nitroglycerin; group III, n = 6), or low-potassium dextran glucose solution (group IV, n = 6), and stored at 4 degrees C for 30 hours. After left single-lung transplantation, the right main bronchus and right pulmonary artery were ligated and the functions of the transplanted lung were assessed for 6 hours. Arterial oxygen tension was significantly higher in group I than in groups II, III, and IV (p < 0.05). Peak inspiratory pressure and wet-to-dry lung weight ratio were significantly lower in group I than in groups II and IV (p < 0.01). Histologic and ultrastructural studies showed better preservation in group I than in groups II, III, and IV. We conclude that the new ET-Kyoto solution provides enhanced 30-hour lung preservation.
Liu
C J
CJ
Department of Thoracic Surgery, Kyoto University, Japan.
Ueda
M
M
Kosaka
S
S
Hirata
T
T
Yokomise
H
H
Inui
K
K
Hitomi
S
S
Wada
H
H
D000818:Animals; D015925:Cryopreservation; D003451:Cryoprotective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000242:Cyclic AMP / Q000378:metabolism; D003911:Dextrans / Q000008:administration & dosage / Q000627:therapeutic use; D004285:Dogs; D004730:Endothelium, Vascular / Q000378:metabolism; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use; D005609:Free Radicals / Q000378:metabolism; D005942:Gluconates / Q000008:administration & dosage / Q000627:therapeutic use*; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006706:Homeostasis; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000627:therapeutic use*; D001239:Inhalation; D007511:Ischemia / Q000378:metabolism; D016040:Lung Transplantation / Q000473:pathology / Q000502:physiology; D009569:Nitric Oxide / Q000378:metabolism; D009926:Organ Preservation; D009929:Organ Size; D010100:Oxygen / Q000097:blood; D010710:Phosphates / Q000008:administration & dosage / Q000627:therapeutic use*; D011188:Potassium / Q000008:administration & dosage / Q000627:therapeutic use; D011312:Pressure; D019946:Propylene Glycol; D011409:Propylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use; D012123:Pulmonary Ventilation; D017382:Reactive Oxygen Species / Q000378:metabolism; D015427:Reperfusion Injury / Q000378:metabolism; D012996:Solutions; D013997:Time Factors; D014199:Trehalose / Q000008:administration & dosage / Q000627:therapeutic use*
D003451:Cryoprotective Agents; D003911:Dextrans; C087059:ET-Kyoto solution; D005609:Free Radicals; D005942:Gluconates; D006895:Hydroxyethyl Starch Derivatives; D010710:Phosphates; D011409:Propylene Glycols; D017382:Reactive Oxygen Species; D012996:Solutions; D009569:Nitric Oxide; D000431:Ethanol; D019946:Propylene Glycol; D014199:Trehalose; D000242:Cyclic AMP; D005947:Glucose; D011188:Potassium; D010100:Oxygen