Document Detail


Beneficial effect of initial warm crystalloid reperfusion in 6-hour lung preservation.
MedLine Citation:
PMID:  7578178     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To achieve successful lung transplantation, it is essential to minimize reperfusion injury occurring as a result of metabolite accumulation during the preservation period or at the time of initial interaction of blood with constricted pulmonary vasculature. Initial reperfusion with warm crystalloid solution may be advantageous in preventing this injury. METHODS: This study was designed to evaluate the effect of low-potassium (4 mmol/L) dextran (1%) solution as the initial warming solution after 6 hours of hypothermic storage. In 23 New Zealand White rabbits the lungs were flushed with low-potassium dextran solution (10 degrees C, 40 ml/kg, 600 cm H2O), excised, inflated with room air, and stored in a low-potassium dextran solution (10 degrees C) for 6 hours. After storage, the lungs were divided into two groups. Group 1 (n = 8) was reperfused with warm low potassium dextran for 4 minutes, at 37 degrees C followed by blood reperfusion for 30 minutes at 37 degrees C. Group II (n = 15) was reperfused only with blood for 30 minutes at 37 C. The mean pulmonary vascular resistance measured during cold flush and prior to storage was similar in both groups (group I = 20.0 +/- 5.9 mm Hg.sec/ml, group II = 19.3 +/- 1.9 mm Hg.sec/ml). RESULTS: During reperfusion, only 4 of the 15 lungs in group II maintained an acceptable (< 80 mm Hg) mean pulmonary artery pressure; six failed immediately. All eight lungs in group I completed the 30-minute reperfusion (p < 0.005). The mean pulmonary artery pressure was significantly less, and effluent oxygen tension was significantly greater in group I during reperfusion. CONCLUSIONS: In this experimental model, initial warm reperfusion with low-potassium dextran ameliorated the deleterious effects of reperfusion, thus providing an environment to improve lung preservation.
Authors:
K Moriyasu; P P McKeown; D Novitzky; T R Snow
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  14     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:    1995 Jul-Aug
Date Detail:
Created Date:  1995-12-12     Completed Date:  1995-12-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  699-705     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of South Florida, Tampa, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Body Temperature Regulation / physiology*
Graft Survival / physiology
Isotonic Solutions
Lung / blood supply
Lung Transplantation / methods*,  physiology
Organ Preservation / methods*
Oxygen / blood
Plasma Substitutes
Pulmonary Wedge Pressure / physiology
Rabbits
Rehydration Solutions
Reperfusion / methods*
Reperfusion Injury / prevention & control*
Vascular Resistance / physiology
Chemical
Reg. No./Substance:
0/Isotonic Solutions; 0/Plasma Substitutes; 0/Rehydration Solutions; 0/crystalloid solutions; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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