Surfactant replacement in reperfusion injury after clinical lung transplantation.
BACKGROUND
Reperfusion injury remains a significant risk factor in the immediate postoperative course after lung transplantation. We report on our initial clinical experience of surfactant replacement in reperfusion injury after clinical lung transplantation.


RESULTS
In 31 consecutive patients, lung (8 single lung, 16 bilateral lung) or heart-lung (7) transplantation was performed. In 6 patients, severe reperfusion injury developed and was treated with continuously nebulized surfactant. Compliance of the allograft increased 40 +/- 25 % within 3 h following treatment with surfactant. Alveolar arterial oxygen gradient decreased by 23 +/- 11 % after 3 h and by 35 +/- 20 % after 6 h. Normal graft function was reestablished within 1-3 days after transplantation. All treated recipients were extubated until the 6th postoperative day. The 30-day mortality for the 31 recipients was 3.3 %, the 1-year survival 84 %.


CONCLUSIONS
Surfactant replacement may become a clinical method for treatment of reperfusion injury after lung transplantation.
Strüber
M
M
Division of Thoracic- and Cardiovascular Surgery, Hannover Medical School, Carl Neuberg Str. 1, 30623 Hannover, Germany. strueber@thg.mh-hannover.de
Hirt
S W
SW
Cremer
J
J
Harringer
W
W
Haverich
A
A
D000328:Adult; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D016041:Heart-Lung Transplantation / Q000009:adverse effects; D006801:Humans; D008168:Lung / Q000187:drug effects; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010767:Phosphorylcholine; D011092:Polyethylene Glycols / Q000494:pharmacology / Q000627:therapeutic use*; D011184:Postoperative Period; D011663:Pulmonary Surfactants / Q000494:pharmacology / Q000627:therapeutic use*; D015427:Reperfusion Injury / Q000188:drug therapy* / Q000209:etiology; D013501:Surface-Active Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D004338:Drug Combinations; D005233:Fatty Alcohols; D011663:Pulmonary Surfactants; D013501:Surface-Active Agents; D010767:Phosphorylcholine; D011092:Polyethylene Glycols; C047049:dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination