Pulmonary preservation with Bretscheider's HTK and Celsior solution in minipigs.
BACKGROUND
Pulmonary preservation with high potassium/low oncotic pressure Euro-Collins (EC) solution is associated with endothelial dysfunction and reduced surfactant function. We compared two low potassium solutions, histidine-tryptophane-ketoglutarate (HTK) and Celsior, to EC in lung ischemia-reperfusion injury.


METHODS
In 19 minipigs, the left lung was perfused in situ with cold preservation solution (EC, n=6; HTK, n=6; Celsior, n=7). Reperfusion was started after 90 min of warm ischemia. The right pulmonary artery and main bronchus were clamped. Bronchoalveolar lavage (BAL) was obtained before ischemia and after 2 h of reperfusion. Surfactant activity was determined from the BAL in a pulsating bubble surfactometer.


RESULTS
Animals in the EC group survived 3.7+/-1.4 h. Six Celsior and five HTK treated animals survived the observation period of 7 h (P<0.001). Compliance of the reperfused lung deteriorated less in both Celsior and HTK groups (P<0.001). In EC and HTK animals, the pO(2)/FiO(2) ratio was lower (P=0.002), and pulmonary vascular resistance was higher (P=0.02) than in Celsior animals. Surfactant function was impaired after reperfusion in all groups.


CONCLUSIONS
Compared to EC, HTK solution showed moderate and Celsior distinct improvement of post-ischemic pulmonary function. However, surfactant function was not well preserved in any group.
Warnecke
Gregor
G
Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Germany.
Strüber
Martin
M
Hohlfeld
Jens M
JM
Niedermeyer
Jost
J
Sommer
Sebastian P
SP
Haverich
Axel
A
D000818:Animals; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology; D004187:Disaccharides; D004573:Electrolytes; D015633:Extravascular Lung Water / Q000378:metabolism; D005947:Glucose; D005971:Glutamates; D005978:Glutathione; D006639:Histidine; D006982:Hypertonic Solutions; D008168:Lung / Q000473:pathology; D016040:Lung Transplantation; D008353:Mannitol; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D010743:Phospholipids / Q000032:analysis; D011189:Potassium Chloride; D011343:Procaine; D011663:Pulmonary Surfactants / Q000032:analysis; D015427:Reperfusion Injury / Q000517:prevention & control; D013500:Surface Tension; D013556:Swine, Miniature
C039984:Bretschneider cardioplegic solution; C088453:Celsior; D004187:Disaccharides; D004573:Electrolytes; C037096:Euro-Collins' solution; D005971:Glutamates; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions; D010743:Phospholipids; D011663:Pulmonary Surfactants; D008353:Mannitol; D006639:Histidine; D011343:Procaine; D011189:Potassium Chloride; D005978:Glutathione; D005947:Glucose