Aprotinin improves pulmonary function during reperfusion in an isolated lung model.
BACKGROUND
We hypothesized that the use of aprotinin would ameliorate the reperfusion injury observed after lung transplantation because of a reduction in the inflammatory response.


METHODS
We used an isolated, whole blood-perfused, ventilated rabbit lung model to study the effects of aprotinin during reperfusion. The control animals (group A, n = 8) underwent lung harvest after pulmonary arterial prostaglandin E1 injection and Euro-Collins preservation flush before saline storage for 18 hours at 4 degrees C. The experimental groups received either a low dose (3,000 KIU/mL; group B, n = 8) or a high dose (10,000 KIU/mL; group C, n = 8) of aprotinin added to the pulmonary flush before storage. Each lung was reperfused at 37 degrees C at a rate of 60 mL/min.


RESULTS
The arterial partial pressure of oxygen values of group B (low-dose aprotinin) were significantly higher than those of group A (control) after 10 minutes of reperfusion (69.19 +/- 5.69 mm Hg versus 264.30 +/- 48.59 mm Hg, respectively, p = 0.001). Similar results were recorded at 20 and at 30 minutes of reperfusion. Similarly, after 10 minutes of reperfusion, the differences between groups A and C were 69.19 +/- 5.69 mm Hg versus 235.91 +/- 28.63 mm Hg, respectively (p = 0.001).


CONCLUSIONS
The addition of aprotinin to the Euro-Collins pulmonary flush significantly improves arterial oxygenation in the early reperfusion period. The enhanced oxygenation suggests that aprotinin may offer protection against early reperfusion injury.
Mathias
M A
MA
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Tribble
C G
CG
Dietz
J F
JF
Nguyen
R P
RP
Shockey
K S
KS
Kern
J A
JA
Kron
I L
IL
D000818:Animals; D007611:Aprotinin / Q000008:administration & dosage / Q000494:pharmacology*; D006982:Hypertonic Solutions; D066298:In Vitro Techniques; D008168:Lung / Q000502:physiology*; D011817:Rabbits; D015424:Reperfusion; D015427:Reperfusion Injury / Q000517:prevention & control; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*
C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D015842:Serine Proteinase Inhibitors; D007611:Aprotinin