Short-term inhaled nitric oxide in canine lung transplantation from non-heart-beating donor.
BACKGROUND
Use of lungs harvested from non-heart-beating donors (NHBDs) would increase the pulmonary donor pool; however, this strategy would have higher risk of early postoperative graft dysfunction due to unavoidable warm ischemic time. We evaluated the effects of short-term inhaled nitric oxide (NO) during reperfusion in canine left single-lung allotransplantation from a non-heart-beating donor.


METHODS
The donor dogs were sacrificed without heparinization and left at room temperature for 3 hours. Then, recipient dogs received a left single-lung allotransplantation. After implantation, the right bronchus and pulmonary artery were ligated. In group 1 (n = 6), NO gas was administered continuously at a concentration of 40 parts per million throughout a 6-hour assessment period. In group 2 (n = 6), NO gas was administered for the initial 1 hour during reperfusion. In group 3 (n = 6), nitrogen gas was administered for control.


RESULTS
Groups treated with NO exhibited lower pulmonary vascular resistance, as well as improved survival and oxygenation. There was no significant difference in these parameters between group 1 and group 2. Myeloperoxidase activity was significantly lower in NO-treated groups.


CONCLUSIONS
Inhaled NO during reperfusion is beneficial in lung transplantation from non-heart beating donors. The beneficial effect is obtained mainly during the first hour of reperfusion.
Takashima
S
S
Department of Surgery II, Okayama University School of Medicine, Japan.
Date
H
H
Aoe
M
M
Yamashita
M
M
Andou
A
A
Shimizu
N
N
D000280:Administration, Inhalation; D000818:Animals; D004285:Dogs; D006085:Graft Survival / Q000187:drug effects; D006323:Heart Arrest; D016040:Lung Transplantation / Q000379:methods*; D009569:Nitric Oxide / Q000008:administration & dosage*; D010101:Oxygen Consumption / Q000187:drug effects; D009195:Peroxidase / Q000378:metabolism; D015424:Reperfusion; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014655:Vascular Resistance / Q000187:drug effects
D009569:Nitric Oxide; D009195:Peroxidase