Document Detail


Retrograde flush and cold storage for twenty-two to twenty-five hours lung preservation with and without prostaglandin E1.
MedLine Citation:
PMID:  9229296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Our previous study showed that retrograde flush through the left atrium is better than antegrade flush in 6-hour lung preservation. Whether it is feasible in long-term lung preservation is not clear. Several studies suggested that prostaglandin E1 may not be necessary in retrograde flush because of the low vascular resistance on the venous side. This study evaluates the effects of retrograde flush and prostaglandin E1 in 24-hour lung preservation. METHODS: Canine donor lungs were retrograde flushed with University of Wisconsin solution. Group A (n = 7) was pretreated with prostaglandin E1. No prostaglandin E1 was used in group B (n = 7). After flush and cold storage at 4 degrees C for 22 to 25 hours, left lung allotransplantation was performed. Measurements were taken before transplantation (baseline), and at 10, 30, 60, and 120 minutes after transplantation while the right pulmonary artery was occluded. RESULTS: After 120 minutes of reperfusion, the oxygen tension and carbon dioxide tension were 643 +/- 24 and 37 +/- 3 mm Hg in group A and 600 +/- 29 and 37 +/- 3 mm Hg in group B, respectively (p = NS). Pulmonary artery pressure (group A vs group B) was 20 +/- 1 versus 28 +/- 2 mm Hg (p < 0.01); right atrium pressure: 4 +/- 1 versus 8 +/- 1 mm Hg (p < 0.01); left pulmonary vascular resistance: 1109 +/- 51 versus 1525 +/- 133 dyne.sec.cm-5 (p < 0.05); airway resistance: 22 +/- 1 versus 24 +/- 1 cm H2O/L/sec (p = NS); lung dynamic compliance: 30 +/- 1 versus 26 +/- 1 cc/cm (p < 0.05) respectively. As compared with the baseline (19 +/- 1), airway resistance was significantly increased after 2 hours of reperfusion in group B (p < 0.05). Electron microscopy revealed that type I pneumocytes, capillary endothelial cells, and epithelial cells of bronchi were well preserved and the contents of lamellar bodies of type II pneumocyte were reduced. CONCLUSIONS: Canine lung was well preserved by retrograde flush and cold storage with University of Wisconsin solution after 24 hours preservation. Pretreatment of prostaglandin E1 is helpful in reducing pulmonary vascular resistance and airway resistance and improving lung dynamic compliance.
Authors:
C Z Chen; R C Gallagher; P Ardery; W Dyckman; S Donabue; H B Low
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Publication Detail:
Type:  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:  16     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-09-18     Completed Date:  1997-09-18     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:  658-66     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hartford Hospital, Conn. 06106, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology
Allopurinol / pharmacology
Alprostadil / pharmacology*
Animals
Capillaries / pathology
Cardioplegic Solutions / pharmacology
Cryopreservation / methods*
Dogs
Female
Glutathione / pharmacology
Insulin / pharmacology
Irrigation / methods
Lung / blood supply
Lung Transplantation / pathology,  physiology*
Male
Microscopy, Electron
Organ Preservation / methods*
Organ Preservation Solutions*
Pulmonary Gas Exchange / drug effects,  physiology
Raffinose / pharmacology
Vascular Resistance / drug effects,  physiology
Vasodilator Agents / pharmacology*
Chemical
Reg. No./Substance:
0/Cardioplegic Solutions; 0/Organ Preservation Solutions; 0/University of Wisconsin-lactobionate solution; 0/Vasodilator Agents; 11061-68-0/Insulin; 315-30-0/Allopurinol; 512-69-6/Raffinose; 58-61-7/Adenosine; 70-18-8/Glutathione; 745-65-3/Alprostadil

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


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