Optimal lung inflation techniques in a rat lung transplantation model: a revisit.
BACKGROUND
Most of the experimental work assessing optimal lung inflation during lung graft preservation was performed in the late 1990s. Since that time, lung preservation before transplantation has been more standardized, and the optimal lung inflation techniques used during lung preservation in the current clinical setting remain undefined. Nonetheless, lung inflation during storage may play a pivotal role in optimal lung preservation.


METHODS
Lewis rat lungs were perfused with and stored in cold, low-potassium dextran solution (Perfadex, Vitrolife, Göteborg, Sweden) for 6 hours at different levels of lung inflation (25, 50, 75, or 100% of vital capacity [VC]). Orthotopic left lung transplantation using cuff techniques was performed in syngeneic Lewis rats. Posttransplant allograft function, expression of proinflammatory mediators, and expression of lung surfactants were evaluated.


RESULTS
Lungs inflated to 75 or 100% VC showed a significantly better oxygenation in blood gas analysis than lungs inflated to 25 or 50% VC. The levels of mRNAs for tumor necrosis factor-α, pro-interleukin-1β, intracellular adhesion molecule 1 were attenuated in lungs inflated to 75 or 100% VC as compared with deflated lungs, suggesting reduced ischemia/reperfusion injury. In addition, transmission electron microscopy demonstrated better preserved lung surfactants in the alveolar space in the lungs inflated to 75 or 100% VC.


CONCLUSIONS
Inflating lungs to 75 or 100% VC during preservation may be beneficial and result in better posttransplant allograft function through attenuated reperfusion injury and better preserved lung surfactants.
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Yugo
Y
Tanaka
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Norihisa
N
Shigemura
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Kentaro
K
Noda
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Tomohiro
T
Kawamura
Division of Transplantation and Thomas E. Starzl Transplantation Institute, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Kumiko
K
Isse
Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
Donna B
DB
Stolz
Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Christian A
CA
Bermudez
D000818:Animals; D007327:Insufflation / Q000379:methods*; D008168:Lung / Q000502:physiology*; D016040:Lung Transplantation; D008297:Male; D023421:Models, Animal; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D051381:Rats; D011917:Rats, Inbred Lew; D014797:Vital Capacity
D019188:Organ Preservation Solutions