Impact of lung preservation solutions, Euro-Collins vs. low-potassium dextran, on early graft function: a review of five clinical studies.
Currently, intracellular fluid type solutions that are prepared by modification of Euro-Collins solution (EC) have been the most commonly used by clinical lung transplant programs, which have been associated with a high rate of reperfusion injury. On the basis of the wealth of experimental data demonstrating the benefit of extracellular fluid type solutions over EC, one of the extracellular solutions, low-potassium dextran solution (LPD), became commercially available and has recently been applied to clinical settings. To date there have been 5 clinical studies comparing the effect of EC with LPD on early lung graft function. This article reviewed these 5 reports to determine whether the beneficial effects of LPD, as observed in experimental settings, can also be identified in clinical lung preservation. Four studies were retrospective reviews and one was a prospective non-randomized study. Of these 5 studies, 3 studies demonstrated significantly improved recipient oxygenation in the LPD group compared with the EC group in the early post-operative period. In addition, a significantly shorter duration on mechanical ventilation in the LPD group was shown in 2 studies, and improved reperfusion scores or pulmonary compliance was shown in one study each. Four of 5 studies concluded that graft preservation with LPD leads to superior early graft function after lung transplantation. The impact of LPD on prolonged lung preservation and also on long term results of graft function will be a subject of future investigation.
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Yoshinori
Y
Okada
Takashi
T
Kondo
D018806:APACHE; D003911:Dextrans; D005947:Glucose; D006801:Humans; D006982:Hypertonic Solutions; D008170:Lung Compliance; D016040:Lung Transplantation; D019188:Organ Preservation Solutions; D010100:Oxygen / Q000032:analysis; D011859:Radiography; D015427:Reperfusion Injury / Q000000981:diagnostic imaging / Q000517:prevention & control; D012121:Respiration, Artificial
D003911:Dextrans; C037096:Euro-Collins' solution; D006982:Hypertonic Solutions; D019188:Organ Preservation Solutions; C083290:low potassium dextran glucose solution; D005947:Glucose; D010100:Oxygen