title: Technique of controlled reperfusion of the transplanted lung in humans.
abstract: BACKGROUND
  Reperfusion injury remains a significant and sometimes fatal problem in clinical lung transplantation. Controlled reperfusion of the transplanted lung using white cell-filtered, nutrient-enriched blood has been shown recently to significantly ameliorate reperfusion damage in a porcine model. We modified this experimental technique and applied it to human lung transplantation.
  
  
  METHODS
  Approximately 1,500 mL of arterial blood was slowly collected in a cardiotomy reservoir during the lung implant, and mixed to make a 4:1 solution of blood:modified Buckberg perfusate. This solution was passed through a leukocyte filter and into the transplant pulmonary artery for 10 minutes, at a controlled rate (200 mL/min) and pressure (less than 20 mm Hg), immediately before removal of the vascular clamp.
  
  
  RESULTS
  Five patients underwent lung transplantation (1 bilateral, 4 single lung) using this technique. All patients were ventilated on a 40% fraction of inspired oxygen within a few hours and extubated on or before the first postoperative day.
  
  
  CONCLUSIONS
  Controlled reperfusion of the transplanted lung with white cell-filtered, nutrient-enriched blood has given excellent functional results in our small initial clinical series.
authors.affiliation: Division of Cardiothoracic Surgery, The University of Texas Medical Branch, Galveston 77555-0528, USA. slick@utmb.edu
authors.forename: S D
authors.initials: SD
authors.lastname: Lick
authors.forename: P S
authors.initials: PS
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Kurusz
authors.forename: R A
authors.initials: RA
authors.lastname: Vertrees
authors.forename: C K
authors.initials: CK
authors.lastname: McQuitty
authors.forename: W E
authors.initials: WE
authors.lastname: Johnston
mesh_terms: D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D015424:Reperfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000517:prevention & control*