Does PGE1 attenuate potassium-induced vasoconstriction in initial pulmonary artery flush on lung preservation?
The standard clinical protocol for lung transplantation employs cold single pulmonary artery flush with Euro-Collins solution or the University of Wisconsin solution. Prostaglandin E1 (PGE1) is usually given by direct injection into the pulmonary artery to reduce pulmonary vasoconstriction caused by these intracellular, high-potassium solutions, however, the efficacy of PGE1 on lung preservation remains controversial. In this study we demonstrated that vasodilator effects of PGE1 were markedly reduced under a high-potassium condition, and that potassium-induced pulmonary vasoconstriction were inhibited by calcium channel blocker nifedipine. There are three therapeutic options in the cold single pulmonary artery flush for optimal lung transplantation, including the use of a higher dose of PGE1, use of the calcium channel blocker instead of PGE1, or the use of the extracellular, low-potassium solution such as low-potassium dextran solution for initial pulmonary artery flush before the lung harvest.
Sasaki
S
S
Department of Cardiovascular Surgery, Hokkaido University, Sapporo, Japan.
Yasuda
K
K
McCully
J D
JD
LoCicero
J
J
D000527:Alprostadil / Q000008:administration & dosage / Q000494:pharmacology*; D000818:Animals; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology; D007269:Injections, Intra-Arterial; D008168:Lung / Q000098:blood supply*; D016040:Lung Transplantation; D008297:Male; D009543:Nifedipine / Q000008:administration & dosage / Q000494:pharmacology; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D011188:Potassium / Q000008:administration & dosage* / Q000494:pharmacology; D011651:Pulmonary Artery; D051381:Rats; D017207:Rats, Sprague-Dawley; D012433:Ryanodine / Q000008:administration & dosage / Q000494:pharmacology; D014661:Vasoconstriction / Q000187:drug effects*; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000494:pharmacology
D002121:Calcium Channel Blockers; D019188:Organ Preservation Solutions; D014665:Vasodilator Agents; D012433:Ryanodine; D000527:Alprostadil; D009543:Nifedipine; D011188:Potassium