24-hour lung preservation: simplified versus conventional University of Wisconsin solution in a porcine model.
BACKGROUND
Experimentally, the University of Wisconsin solution (UW) has been shown to be superior to the EuroCollins solution (EC) for lung graft preservation. We showed previously that the inclusion of the trisaccharide raffinose as an impermeant in the UW is largely responsible for this superiority. In this study, we used a new porcine model of isolated lung reperfusion to evaluate the use of a simple solution of phosphate-buffered raffinose (PBr) for lung preservation.


METHODS
Lungs were stored for 24 hr at 4 degrees C after a single pulmonary artery flush with either UW (n = 5) or PBr (n = 5) solution. Left lungs were ventilated with room air and reperfused for 4 hr by venovenous extracorporeal circulation from a support animal. Controls (n = 5) were flushed with UW and reperfused without storage.


RESULTS
Control lungs performed better than those stored in either solution in terms of oxygenation (P = 0.034) and airway pressure (P = 0.032). There were no significant differences between the two stored groups for any parameters. Data for stored lungs after 4 hr of reperfusion (means with 95% confidence intervals) include oxygenation (mm Hg): control 101.6 (14.5), UW 85.2 (14.5), PBr 75.0 (14.5); blood flow (ml/ min): control 572 (90), UW 466 (90), PBr 468 (90); peak airway pressure (mm Hg): control 15.9 (3.0), UW 21.0 (3.0), PBr 22.6 (3.0); pulmonary artery pressure (mm Hg): control 17.5 (3.2), UW 22.3 (2.9), PBr 24.5 (2.9). Graft edema (percentage tissue water): control 86.4 (0.8), UW 89.9 (1.8), PBr 89.3 (1.0).


CONCLUSIONS
PBr is a far simpler and less expensive alternative to UW, and appears to provide a similar level of lung graft protection.
Wright
N C
NC
Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester, United Kingdom.
Hopkinson
D N
DN
Shaw
T E
TE
Hooper
T L
TL
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D002021:Buffers; D015925:Cryopreservation; D005069:Evaluation Studies as Topic; D005112:Extracorporeal Circulation; D005978:Glutathione; D007328:Insulin; D008168:Lung / Q000502:physiology; D019188:Organ Preservation Solutions; D010710:Phosphates; D011652:Pulmonary Circulation; D011887:Raffinose; D015424:Reperfusion; D013552:Swine; D013997:Time Factors
D002021:Buffers; D007328:Insulin; D019188:Organ Preservation Solutions; D010710:Phosphates; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose