| Combined use of prostacyclin and higher perfusate temperatures further enhances the superior lung preservation by Celsior solution in the isolated rat lung. | |
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MedLine Citation:
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PMID: 10452345 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The poor tolerance of the lung to ischemia and reperfusion (IR) still represents one of the limitations in clinically successful lung transplantation. Modified Euro-Collins (EC) is routinely used in lung preservation, but alternative solutions have been developed for improvement of pulmonary preservation. Celsior is an extracellular solution that has significantly reduced the IR-induced pulmonary damage in animal studies. So far, no extensive experimental studies exist concerning the influence of Celsior on pulmonary gas exchange following IR. METHODS: In an extracorporeal rat lung model 10 lungs, each, were preserved with Celsior (CE) and Celsior/prostacyclin (CEPC, 6 microg/100 ml) at 4 degrees and 15 degrees C, each, and compared to low-potassium Euro-Collins (EC-40, 40 mmol/liter potassium). After 2 hours of ischemia lungs were reventilated and reperfused using a roller pump. Oxygenation in terms of oxygen partial tension in the left atrial effluent, pulmonary vascular resistance (PVR), peak inspiratory pressure, and wet/dry ratio were monitored for 50 minutes. Furthermore, edema formation was evaluated by light microscopy. Statistical analysis was performed using ANOVA models. RESULTS: Compared to the EC-40 group, oxygenation was increased and amount of edema was reduced in most Celsior-preserved organs (p<0.032) with exception of the CEPC group at 4 degrees C (p = 0.06). Additional application of prostacyclin did not have any significant effect on oxygenation in the Celsior group. However, after temperature elevation of the CEPC perfusate to 15 degrees C, a superior partial tension of oxygen was observed (p<0.023) in contrast to the 4 degrees C groups CE and CEPC. The lowest PVR was found in the CE 4 degrees C group (p<0.02). CONCLUSIONS: Celsior provides better lung preservation than EC-40 solution. Application of prostacyclin at higher perfusate temperatures results in additional functional improvement. In vivo experiments and ultrastructural analysis are warranted for further evaluation of Celsior in lung preservation. |
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Authors:
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T Wittwer; T Wahlers; A Fehrenbach; J F Cornelius; S Elki; M Ochs; H Fehrenbach; J Albes; A Haverich; J Richter |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 18 ISSN: 1053-2498 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-09-28 Completed Date: 1999-09-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 684-92 Citation Subset: IM |
Affiliation:
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Division of Cardiothoracic and Vascular Surgery, Medical School Hannover, Germany. Th.Wittwer-MD@t-online.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Disaccharides / pharmacology Electrolytes / pharmacology Epoprostenol / pharmacology* Glutamates / pharmacology Glutathione / pharmacology Histidine / pharmacology Hypertonic Solutions / pharmacology Lung / anatomy & histology, drug effects*, physiology Male Mannitol / pharmacology Organ Preservation / methods*, statistics & numerical data Organ Preservation Solutions / pharmacology* Oxygen / physiology Partial Pressure Perfusion / methods, statistics & numerical data Rats Rats, Sprague-Dawley Temperature |
| Chemical | |
Reg. No./Substance:
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0/Celsior; 0/Disaccharides; 0/Electrolytes; 0/Euro-Collins' solution; 0/Glutamates; 0/Hypertonic Solutions; 0/Organ Preservation Solutions; 35121-78-9/Epoprostenol; 69-65-8/Mannitol; 70-18-8/Glutathione; 71-00-1/Histidine; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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