title: Ultrafiltration attenuates cardiopulmonary bypass-induced acute lung injury in a canine model of single-lung transplantation.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effects of cardiopulmonary bypass and ultrafiltration on graft function in a canine single-lung transplantation model.
  
  
  METHODS
  Fifteen left single-lung transplantations were done in weight-mismatched canine pairs. The animals were divided into 3 groups: group 1, in which transplantation was done without cardiopulmonary bypass; group 2, in which transplantation was done with cardiopulmonary bypass and in which the cardiopulmonary bypass flow was decreased slowly with controlled pulmonary artery pressure; and group 3, in which transplantation was done with cardiopulmonary bypass and ultrafiltration. Hemodynamic parameters and lung function were monitored for 6 hours after reperfusion. The grafts were harvested for histologic studies, myeloperoxidase assay, and real-time quantitative reverse transcription-polymerase chain reaction of mRNA encoding interleukin 6.
  
  
  RESULTS
  The hemodynamic parameters were similar among the 3 groups. In group 1 PaO2 and alveolar to arterial gradient for O2 levels were excellent throughout the 6-hour observation period, but in group 2 they progressively deteriorated. However, ultrafiltration significantly (P = .02) improved the PaO2 level in group 3. On histology, interstitial edema and polynuclear cell infiltration were most marked in group 2 and significantly worse than in groups 1 and 3. Myeloperoxidase assay and real-time quantitative reverse transcription-polymerase chain reaction showed increased myeloperoxidase activity and interleukin 6 gene expression in group 2 grafts compared with group 1 grafts. Myeloperoxidase activity and interleukin 6 gene expression were suppressed with ultrafiltration.
  
  
  CONCLUSIONS
  Cardiopulmonary bypass had negative effects on the graft, but ultrafiltration attenuated acute lung dysfunction by reducing the inflammatory response.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Saitoh
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsuchida
authors.forename: Terumoto
authors.initials: T
authors.lastname: Koike
authors.forename: Koichi
authors.initials: K
authors.lastname: Satoh
authors.forename: Manabu
authors.initials: M
authors.lastname: Haga
authors.forename: Tadashi
authors.initials: T
authors.lastname: Aoki
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Toyabe
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Hayashi
mesh_terms: D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004195:Disease Models, Animal; D004285:Dogs; D006440:Hemofiltration; D016040:Lung Transplantation / Q000502:physiology*; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000517:prevention & control*