title: Beneficial effect of polyethylene glycol in lung preservation: early evaluation by proton nuclear magnetic resonance spectroscopy.
abstract: BACKGROUND
  Proton nuclear magnetic resonance spectroscopy can be used to measure organic molecules in biological fluids. In this study, proton nuclear magnetic resonance spectroscopy of bronchoalveolar lavage was assessed to detect cellular damage in lung transplants. Also we evaluated a polyethylene glycol solution in lung preservation.
  
  
  METHODS
  An isolated perfused and working pig lung was used to assess initial pulmonary function after in situ cold flush and cold storage for 6 hours in three preservation solutions: (1) Euro-Collins solution, (2) University of Wisconsin solution, and (3) low potassium solution with polyethylene glycol (PEG). Pulmonary vascular resistance and partial pressure of arterial oxygen were measured during reperfusion. Bronchoalveolar lavage was studied by proton nuclear magnetic resonance spectroscopy and a histologic study of the lungs was done at the harvest after ischemia and after reperfusion.
  
  
  RESULTS
  Partial pressure of arterial oxygen and pulmonary vascular resistance were significantly better in PEG compared with Euro-Collins solution (p = 0.011). Interstitial edema was significantly higher in Euro-Collins solution (2.4 +/- 0.24; p = 0.02) and University of Wisconsin solution (2.7 +/- 0.20; p = 0.0003) than PEG (2 +/- 0.16). Mitochondria scale was better in PEG (8.1 +/- 0.46) than in Euro-Collins solution (6.2 +/- 0.37; p = 0.0001) or University of Wisconsin solution (5.6 +/- 1.36; p = 0.0046). In bronchoalveolar lavage proton nuclear magnetic resonance spectroscopy spectra, lactate, pyruvate, citrate, and acetate were only detected after reperfusion, with a significantly reduced production of acetate in PEG. Pyruvate was reduced at the limit of significance in PEG versus University of Wisconsin solution.
  
  
  CONCLUSIONS
  Proton nuclear magnetic resonance spectroscopy seems to be a simple and suitable method for assessment of early injury to the lung transplant. In this experimental study, PEG preserved the lung better than University of Wisconsin solution and Euro-Collins solution in both the proton nuclear magnetic resonance spectroscopy study as well as the physiologic study.
authors.affiliation: Cardiothoracic Unit, Poitiers, France. c.jayle@chu-poitiers.fr
authors.forename: Christophe
authors.initials: C
authors.lastname: Jayle
authors.forename: Pierre
authors.initials: P
authors.lastname: Corbi
authors.forename: Michel
authors.initials: M
authors.lastname: Eugene
authors.forename: Michel
authors.initials: M
authors.lastname: Carretier
authors.forename: William
authors.initials: W
authors.lastname: Hebrard
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Menet
authors.forename: Thierry
authors.initials: T
authors.lastname: Hauet
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis; D008168:Lung / Q000378:metabolism*; D016040:Lung Transplantation; D009682:Magnetic Resonance Spectroscopy; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D011092:Polyethylene Glycols; D013552:Swine; D013997:Time Factors
chemical_list: D019188:Organ Preservation Solutions; D011092:Polyethylene Glycols