Pulmonary preservation studies: effects on endothelial function and pulmonary adenine nucleotides.
BACKGROUND
Lung transplantation is an effective therapy plagued by a high incidence of early graft dysfunction, in part because of reperfusion injury. The optimal preservation solution for lung transplantation is unknown. We performed experiments using an isolated perfused rat lung model to test the effect of lung preservation with three solutions commonly used in clinical practice.


METHODS
Lungs were retrieved from Sprague-Dawley rats and flushed with one of three solutions: modified Euro-Collins (MEC), University of Wisconsin (UW), or low potassium dextran and glucose (LPDG), then stored cold for varying periods before reperfusion with Earle's balanced salt solution using the isolated perfused rat lung model. Outcome measures were capillary filtration coefficient (Kfc), wet-to-dry weight ratio, and lung tissue levels of adenine nucleotides and cyclic AMP.


RESULTS
All lungs functioned well after 4 hr of storage. By 6 hr, UW-flushed lungs had a lower Kfc than LPDG-flushed lungs. After 8 hr of storage, only UW-flushed lungs had a measurable Kfc. Adenine nucleotide levels were higher in UW-flushed lungs after prolonged storage. Cyclic AMP levels correlated with Kfc in all groups.


CONCLUSIONS
Early changes in endothelial permeability seemed to be better attenuated in lungs flushed with UW compared with LPDG or MEC; this was associated with higher amounts of adenine nucleotides. MEC-flushed lungs failed earlier than LPDG-flushed or UW-flushed lungs. The content of the solution may be more important for lung preservation than whether the ionic composition is intracellular or extracellular.
Paik
Hyo Chae
HC
Kangnamku Dogokdong 146-92, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Hoffmann
Steven C
SC
Egan
Thomas M
TM
D000227:Adenine Nucleotides / Q000378:metabolism*; D000241:Adenosine / Q000494:pharmacology; D000244:Adenosine Diphosphate / Q000378:metabolism; D000249:Adenosine Monophosphate / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000378:metabolism; D000493:Allopurinol / Q000494:pharmacology; D000818:Animals; D002199:Capillary Permeability / Q000187:drug effects; D000242:Cyclic AMP / Q000378:metabolism; D003911:Dextrans / Q000494:pharmacology; D004730:Endothelium, Vascular / Q000378:metabolism; D005947:Glucose / Q000494:pharmacology; D005978:Glutathione / Q000494:pharmacology; D006982:Hypertonic Solutions / Q000494:pharmacology*; D007328:Insulin / Q000494:pharmacology; D008168:Lung / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D016040:Lung Transplantation; D008297:Male; D019188:Organ Preservation Solutions / Q000494:pharmacology*; D009929:Organ Size; D011887:Raffinose / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D014867:Water
D000227:Adenine Nucleotides; D003911:Dextrans; C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; C083290:low potassium dextran glucose solution; D014867:Water; D000249:Adenosine Monophosphate; D000244:Adenosine Diphosphate; D000493:Allopurinol; D000255:Adenosine Triphosphate; D000242:Cyclic AMP; D005978:Glutathione; D005947:Glucose; D000241:Adenosine; D011887:Raffinose