SP-A-enriched surfactant for treatment of rat lung transplants with SP-A deficiency after storage and reperfusion.
BACKGROUND
The function of pulmonary surfactant is affected by lung transplantation, contributing to impaired lung transplant function. A decreased amount of surfactant protein-A (SP-A) after reperfusion is believed to contribute to the impaired surfactant function. Surfactant treatment has been shown to improve lung transplant function, but the effect is variable. We investigated whether SP-A enrichment of surfactant improved the efficacy of surfactant treatment in lung transplantation.


METHODS
Left and right lungs of Lewis rats, inflated with 50% O2, were stored for 20 hr at 8 degrees C. Surfactant in bronchoalveolar lavage fluid from right lungs was investigated after storage (n=6). Left lungs were transplanted into syngeneic recipients and treated with SP-A-deficient surfactant (n=6) or SP-A-enriched surfactant (n=6) just before reperfusion. Air was instilled into untreated lung transplants (n=6). Sham operated (n=4) and normal (n=8) animals served as controls. Lung function was measured during 1 hr of reperfusion; surfactant components in bronchoalveolar lavage fluid were measured after reperfusion.


RESULTS
After storage the amount of SP-A decreased by 27%, whereas surfactant phospholipids changed minimally. After reperfusion a further decrease of SP-A was paralleled by profound changes in surfactant phospholipids. Lung transplant function, however, remained relatively good. After instillation of SP-A-enriched surfactant, PO2 values were reached that approximated sham control PO2 values, whereas after SP-A-deficient surfactant treatment, the PO2 values did not improve.


CONCLUSIONS
Enrichment of surfactant with SP-A for treatment of lung transplants improves the efficacy of surfactant treatment.
Erasmus
Michiel E
ME
Department of Cardiopulmonary Surgery, Research Division, University Hospital Groningen, Groningen, The Netherlands.
Hofstede
Gert J H
GJ
Petersen
Arjen H
AH
Batenburg
Joseph J
JJ
Haagsman
Henk P
HP
Oetomo
Sidarto Bambang
SB
Prop
Jochum
J
D000818:Animals; D003080:Cold Temperature; D016040:Lung Transplantation; D008297:Male; D009926:Organ Preservation; D010100:Oxygen / Q000097:blood; D011510:Proteolipids / Q000627:therapeutic use*; D037662:Pulmonary Surfactant-Associated Protein A; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000172:deficiency / Q000627:therapeutic use*; D051381:Rats; D011917:Rats, Inbred Lew; D015424:Reperfusion
D011510:Proteolipids; D037662:Pulmonary Surfactant-Associated Protein A; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; D010100:Oxygen