Influence of different routes of flush perfusion on the distribution of lung preservation solutions in parenchyma and airways.
OBJECTIVE
The present study was performed to investigate the influence of different routes of perfusion on the distribution of the preservation solutions in the lung parenchyma and upper airways.


METHODS
Pigs were divided into four groups: control (n = 6), pulmonary artery (PA) (n = 6), simultaneous PA + bronchial artery (BA) (n = 8), and retrograde delivery (n = 6). After preparation and cannulation, cardioplegia solution and Euro-Collins solution (ECS) for lung preservation were given simultaneously. After removal of the heart, the double lung bloc was harvested. Following parameters were assessed: total and regional perfusion (dye-labeled microspheres), tissue water content, PA, aorta, left atrial and left ventricular pressures, cardiac output and lung temperature.


RESULTS
Our data show that flow of the ECS in lung parenchyma did not reach control values (9.4+/-1.0 ml/min per g lung wet weight) regardless of the route of delivery (PA 6.3+/-1.5, PA + BA 4.8+/-0.9, retrograde 2.7+/-0.9 ml/min per g lung wet weight). However, flow in the proximal and distal trachea were significantly increased by PA + BA delivery (0.970+/-0.4, respectively, 0.380+/-0.2 ml/min per g) in comparison with PA (0.023+/-0.007, respectively, 0.024+/-0.070 ml/min per g), retrograde (0.009+/-0.003, respectively, 0.021+/-0.006 ml/min per g) and control experiments (0.125+/-0.0018, respectively, 0.105+/-0.012 ml/g per min). Similarly the highest flow rates in the right main bronchus were achieved by PA + BA delivery (1.04+/-0.4 ml/min per g) in comparison with 0.11+/-0.03 in control, 0.033+/-0.008 in PA, and 0.019+/-0.005 ml/min per g in retrograde group. Flows in the left main bronchus were 0.09+/-0.02 ml/min per g in control, 0.045+/-0.012 ml/min per g in PA, and 0.027+/-0.006 ml/min per g in retrograde group. The flow rates were significantly (P = 0.001) increased by PA + BA delivery of the storage solution (0.97+/-0.3 ml/min per g).


CONCLUSIONS
Our data show that the distribution of ECS for lung preservation is significantly improved in airway tissues (trachea and bronchi) if a simultaneous PA + BA delivery is used.
Bitu-Moreno
J
J
Department of Cardiovascular Surgery, Albert-Ludwigs-University Freiburg, Germany.
Francischetti
I
I
Siemer
R
R
Matheis
G
G
Baretti
R
R
Maffei
F H
FH
Kreitmayr
B
B
Beyersdorf
F
F
D000818:Animals; D001980:Bronchi / Q000098:blood supply / Q000378:metabolism; D006982:Hypertonic Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics; D008168:Lung / Q000378:metabolism; D008297:Male; D019188:Organ Preservation Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics*; D012039:Regional Blood Flow; D012137:Respiratory System / Q000098:blood supply / Q000378:metabolism*; D013552:Swine; D014018:Tissue Distribution; D014132:Trachea / Q000098:blood supply / Q000378:metabolism
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions