Significance of cyclic adenosine monophosphate and nitroglycerin in ET-Kyoto solution for lung preservation.
BACKGROUND
We previously demonstrated that the supplement of both dibutyryl cyclic adenosine monophosphate (db-cAMP) and nitroglycerin to the conventional ET-Kyoto solution improved lung preservation significantly. However, the significance of each component in lung preservation remained unclear. We examined the efficacy of the two components on lung preservation in the current study.


METHODS
Rat lung grafts (eight per group) were studied in an isolated lung perfusion model. Group 1 grafts were flushed and preserved with ET-Kyoto solution containing 2 mmol/L of db-cAMP. Group 2 grafts were flushed and preserved with ET-Kyoto solution containing 100 mg/L of nitroglycerin. In group 3, the grafts were flushed and preserved with ET-Kyoto solution containing neither db-cAMP nor nitroglycerin as control group. After 4-hour cold storage, the lung grafts were reperfused for 50 minutes.


RESULTS
The lung grafts in groups 1 and 2 showed significantly better lung function after reperfusion than those in group 3 with regard to arterial oxygen tension, shunt fraction, peak inspiratory airway pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance. The supplementation of db-cAMP improved especially the pulmonary arterial pressure and pulmonary vascular resistance, while the supplementation of nitroglycerin improved especially the oxygenation and airway pressure of the grafts.


CONCLUSIONS
Both of db-cAMP and nitroglycerin had beneficial effects on lung preservation and are essential to the ET-Kyoto solution. There was a difference between the two components in the effects on preserved lungs.
Bando
T
T
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany. bando@kuhp.kyoto-u.ac.jp
Albes
J M
JM
Schöne
J
J
Wada
H
H
Hitomi
S
S
Wahlers
T
T
Schäfers
H J
HJ
D000818:Animals; D000242:Cyclic AMP / Q000494:pharmacology*; D005069:Evaluation Studies as Topic; D005942:Gluconates; D006895:Hydroxyethyl Starch Derivatives; D016040:Lung Transplantation; D008297:Male; D005996:Nitroglycerin / Q000494:pharmacology*; D019188:Organ Preservation Solutions; D010710:Phosphates; D051381:Rats; D017207:Rats, Sprague-Dawley; D015424:Reperfusion; D014199:Trehalose
C087059:ET-Kyoto solution; D005942:Gluconates; D006895:Hydroxyethyl Starch Derivatives; D019188:Organ Preservation Solutions; D010710:Phosphates; D014199:Trehalose; D000242:Cyclic AMP; D005996:Nitroglycerin