Relative importance of prostaglandin/cyclic adenosine monophosphate and nitric oxide/cyclic guanosine monophosphate pathways in lung preservation.
BACKGROUND
Modulation of vascular tone and platelet and neutrophil function through the prostaglandin/cyclic adenosine monophosphate or nitric oxide/cyclic guanosine monophosphate pathway can benefit lung graft function. The relative importance of these pathways is unclear.


METHODS
Rat lung grafts (5 per group) were studied in an ex vivo reperfusion model. Group I grafts were pretreated with prostacyclin (20 ng.kg-1.min-1), flushed with cold Euro-Collins solution containing prostacyclin (200 micrograms/L), and reperfused immediately for 1 hour. Group II grafts were similarly procured but were stored at 4 degrees C for 6 hours before reperfusion. In group III, no prostacyclin therapy was used; instead, the nitric oxide donor glyceryl trinitrate (0.1 mg/mL) was added to the flush/storage solution, and the grafts were stored for 6 hours.


RESULTS
Group II grafts performed poorly compared with those in group I, with substantial deterioration of oxygenation and blood flow and elevation of pulmonary artery pressure, peak airway pressure, and wet to dry weight ratio. In contrast, graft function in group III was similar to that in controls.


CONCLUSIONS
Lung graft integrity after storage in Euro-Collins solution was better preserved by glyceryl trinitrate than by prostacyclin in this model.
Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester, United Kingdom.
M S
MS
Bhabra
D N
DN
Hopkinson
T E
TE
Shaw
T L
TL
Hooper
D000818:Animals; D015925:Cryopreservation; D000242:Cyclic AMP / Q000502:physiology; D006152:Cyclic GMP / Q000502:physiology; D004353:Drug Evaluation, Preclinical; D011464:Epoprostenol; D006085:Graft Survival; D006982:Hypertonic Solutions; D016040:Lung Transplantation / Q000502:physiology*; D008297:Male; D009569:Nitric Oxide / Q000502:physiology; D005996:Nitroglycerin; D009926:Organ Preservation / Q000379:methods*; D011453:Prostaglandins / Q000502:physiology; D051381:Rats; D017207:Rats, Sprague-Dawley; D015424:Reperfusion / Q000379:methods*
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D011453:Prostaglandins; D009569:Nitric Oxide; D011464:Epoprostenol; D000242:Cyclic AMP; D005996:Nitroglycerin; D006152:Cyclic GMP