Comparison of effectiveness of intracellular and extracellular preservation solution on attenuation in ischemic-reperfusion lung injury in rats.
BACKGROUND
Human lung allografts can only be preserved for 6 hours. Experimental interventions that reduce ischemia-reperfusion (I/R) lung injury can be used to improve the properties of the preservation solution. The best solution for lung preservation is still a matter of controversy. The purpose of this study was to compare the protective effects of various solutions on I/R lung injury in Sprague-Dawley rats.


METHODS
The following solutions were compared: a physiological salt solution; an intracellular preservation solution (the University of Wisconsin Solution, UW); an extracellular preservation solution (EP3); and the extracellular preservation solution with the addition of various protective agents--EP3 plus dexamethasone (Dex) (EP3-a), plus glutathione (GLU) and allopurinol (ALL) (EP3-b), and EP3 plus GLU, ALL, lactobionate (LACT), and raffinose (RAF) (EP3-c). I/R lung injury was induced by ischemia for either 45 or 60 minutes, followed by reperfusion for 60 minutes. Hemodynamic changes, lung weight gain (LWG), and capillary filtration coefficients were measured.


RESULTS
Both EP3 and UW preservation solutions had partial attenuation effects on I/R lung injury, but UW produced a better attenuation effect than EP3. Use of modified EP3 solutions containing either protective agents (GLU, ALL, or Dex) or impermeants (LACT and RAF) improved the ability of EP3 to reduce I/R lung injury. The LWG using the modified EP3-c solution was the lowest among all groups. UW induced pulmonary hypertension. After I/R challenge, pulmonary arterial pressure with EP3-c was lower than with UW. Based on a lower LWG and the changes in hemodynamics, EP3-c is a better lung preservation solution than UW and EP3.


CONCLUSIONS
Based on the attenuation of I/R injury, we conclude that there is no significant difference between intracellular UW and extracellular (EP3-a, EP3-b) preservation solutions in this rat model, but the addition of protective agents and impermeants to the solution are important. The findings suggest that EP3-c might be a better lung preservation solution than UW.
Chiang
C H
CH
Pulmonary Department, Taipei Veterans General Hospital, National Yang-Ming University, Taipei.
D000241:Adenosine / Q000494:pharmacology; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D003911:Dextrans; D005947:Glucose; D005978:Glutathione / Q000494:pharmacology; D006439:Hemodynamics; D006493:Heparin; D007328:Insulin / Q000494:pharmacology; D007511:Ischemia / Q000150:complications*; D008168:Lung / Q000098:blood supply*; D016040:Lung Transplantation; D008297:Male; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D009929:Organ Size; D010710:Phosphates; D011239:Prednisolone; D011887:Raffinose / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000517:prevention & control*
D003911:Dextrans; C087055:Ep4 solution; D007328:Insulin; D019188:Organ Preservation Solutions; D010710:Phosphates; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D006493:Heparin; D011239:Prednisolone; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose