Document Detail

Pulmonary cell death in warm ischemic rabbit lung is related to the alveolar oxygen reserve.
MedLine Citation:
PMID:  9588586     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: If lungs could be retrieved for transplantation from non-heart-beating cadavers, the shortage of donors might be significantly alleviated. METHODS: We studied the effect of different postmortem lung conditions on pulmonary cell death. Lungs from 208 New Zealand white rabbits were flushed with trypan blue vital dye solution at intervals after circulatory arrest, fixed, and mounted for histologic examination. Pulmonary cells were judged to be viable on the basis of their ability to exclude trypan blue dye. In the control group, lungs were excised immediately after death and immersed in cold (4 degrees C) saline solution. In the other groups, cadavers were left at room temperature with lungs deflated, ventilated with room air or 100% oxygen or 100% nitrogen, or inflated with room air or 100% oxygen. RESULTS: There was a gradual increase in percentage (mean +/- SEM) of nonviable cells in the control group from 2.5%+/-0.9% (preischemic value) to 18.1%+/-2.8% at 24 hours after death (p < 0.001). In cadavers with lungs deflated, 79.7%+/-2.1% of cells were nonviable at 24 hours after circulatory arrest (p < 0.001 versus control group). In contrast, room air-ventilated cadavers showed only 21.4%+/-2.7% nonviable cells at this interval (p < 0.001 versus deflated group; not significant versus control group). Values in oxygen-ventilated animals were similar. Nitrogen-ventilated cadavers, however, had significantly more nonviable lung cells (73.8%+/-3.2%; p < 0.001 vs room air and oxygen-ventilated group, not significant vs deflated group). Oxygen-inflated lungs showed a parallel decrease in cell viability up to 4 hours after death when compared with room air-inflated cadaveric lungs, but thereafter more cells became nonviable in the latter group (11.1%+/-0.7% vs 19.6%+/-3.2% at 6 hours and 48.7%+/-7.2% vs 75.5%+/-4.6% at 24 hours, respectively; p < 0.01). CONCLUSIONS: Postmortem room air ventilation is as good as oxygen ventilation in delaying pulmonary cell death, and its effect is comparable to cold storage; nitrogen ventilation, however, is ineffective and not different from deflation; oxygen inflation will preserve ischemic cells for longer intervals as opposed to room air inflation. Therefore the alveolar oxygen reserve seems to be the critical factor to protect-the lung parenchyma from warm ischemic damage.
J Q Kuang; D E Van Raemdonck; N C Jannis; P R De Leyn; E K Verbeken; W J Flameng; T E Lerut
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  17     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-07-09     Completed Date:  1998-07-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  406-14     Citation Subset:  IM    
Center for Experimental Surgery and Anesthesiology, Katholieke Universiteit Leuven, University Hospitals, Belgium.
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MeSH Terms
Cell Death
Cell Survival
Coloring Agents / diagnostic use
Glucose / therapeutic use
Heart Arrest / pathology,  physiopathology
Ischemia / pathology,  physiopathology
Lung / metabolism,  pathology*
Nitrogen / administration & dosage
Organ Preservation*
Organ Preservation Solutions / therapeutic use
Oxygen / administration & dosage
Oxygen Consumption / physiology*
Postmortem Changes
Pulmonary Alveoli / metabolism*
Pulmonary Atelectasis / physiopathology
Respiration, Artificial
Sodium Chloride / therapeutic use
Time Factors
Tromethamine / therapeutic use
Trypan Blue / diagnostic use
Reg. No./Substance:
0/Coloring Agents; 0/Krebs-Henseleit solution; 0/Organ Preservation Solutions; 50-99-7/Glucose; 72-57-1/Trypan Blue; 7647-14-5/Sodium Chloride; 77-86-1/Tromethamine; 7727-37-9/Nitrogen; 7782-44-7/Oxygen

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

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