Beneficial effects of leukocyte-depleted blood and low-potassium dextran solutions on microvascular permeability in preserved porcine lung.
Modified Euro-Collins (EC) solution, a crystalloid intracellular-type solution, has been commonly used for pulmonary preservation. Several experimental studies have shown the advantages of using extracellular colloid-based solutions. The aim of this study was to compare the quality of preservation of two extracellular colloid solutions, leukocyte-depleted blood (BL) and low-potassium dextran (LPD) solutions, with that of EC solution. Lungs of 22 domestic pigs were flushed and preserved with EC (n = 8), BL (n = 7), or LPD (n = 7) solution. After harvesting, one of the lungs was reperfused immediately in an ex vivo circuit (control lungs), whereas the contralateral lung was reperfused after 8 h of cold (4 degrees C) storage (preserved lungs). Besides the lung function parameters (gas exchange, pulmonary hemodynamics and mechanics), the permeability of the endothelial-epithelial barrier was assessed by determining the transferrin leak index (TLI) using a double radioisotopic method, by measuring the alveolar/arterial protein concentration ratio, and by analyzing histopathologic changes. The functional quality (oxygenation, airway resistance, dynamic compliance [CL, dyn]) of both BL and LPD lungs was slightly but significantly superior to that of EC lungs. However, pulmonary vascular resistance was lower in BL-preserved than in EC- or LPD-preserved lungs. The TLI was increased in EC control and preserved lungs, whereas it was low in BL and LPD control lungs and did not increase after preservation. The alveolar/arterial protein concentration ratio was not different between control groups, but was increased fourfold in EC-preserved compared with BL- or LPD-preserved lungs. Finally, EC-preserved lungs presented a weight gain about twice that of BL- and LPD-preserved lungs. Morphologic analysis confirmed these results, because in the EC-preserved lungs, rupture of alveolar septa and severe alveolar edema and hemorrhage were observed, whereas BL- and LPD-preserved lungs showed a relatively well-preserved structure. The results demonstrate that both BL and LPD flush solutions preserve the endothelial-epithelial barrier better than does EC solution. Although the quality of preservation is similar, pulmonary vascular resistance is higher in LPD-preserved than in BL-preserved lungs.
Schneuwly
O D
OD
Divisions of Anesthesiological Investigations, Nuclear Medicine, Clinical Pathology, and Pneumology, Unit of Thoracic Surgery, University Hospital of Geneva, Geneva, Switzerland.
Licker
M
M
Pastor
C M
CM
Schweizer
A
A
Slosman
D O
DO
Kapanci
Y
Y
Nicod
L P
LP
Robert
J
J
Spiliopoulos
A
A
Morel
D R
DR
D000818:Animals; D001769:Blood; D002199:Capillary Permeability / Q000187:drug effects / Q000502:physiology; D003911:Dextrans / Q000494:pharmacology*; D005260:Female; D006982:Hypertonic Solutions / Q000494:pharmacology; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008170:Lung Compliance / Q000502:physiology; D016040:Lung Transplantation / Q000473:pathology / Q000502:physiology*; D008176:Lung Volume Measurements; D008212:Lymphocyte Depletion; D008297:Male; D009926:Organ Preservation; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood; D011188:Potassium / Q000494:pharmacology*; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000502:physiology; D013552:Swine
D003911:Dextrans; C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions; D011188:Potassium; D010100:Oxygen