title: SP-A-enriched surfactant for treatment of rat lung transplants with SP-A deficiency after storage and reperfusion.
abstract: 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.
authors.affiliation: Department of Cardiopulmonary Surgery, Research Division, University Hospital Groningen, Groningen, The Netherlands.
authors.forename: Michiel E
authors.initials: ME
authors.lastname: Erasmus
authors.forename: Gert J H
authors.initials: GJ
authors.lastname: Hofstede
authors.forename: Arjen H
authors.initials: AH
authors.lastname: Petersen
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Batenburg
authors.forename: Henk P
authors.initials: HP
authors.lastname: Haagsman
authors.forename: Sidarto Bambang
authors.initials: SB
authors.lastname: Oetomo
authors.forename: Jochum
authors.initials: J
authors.lastname: Prop
mesh_terms: 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
chemical_list: D011510:Proteolipids; D037662:Pulmonary Surfactant-Associated Protein A; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; D010100:Oxygen