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The Annals of Thoracic Surgery, Vol 58, 845-850, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Lung preservation with Euro-Collins, University of Wisconsin, Wallwork, and low-potassium-dextran solution. Universite++ Paris-Sud Lung Transplant Group

L Xiong, M Mazmanian, AR Chapelier, J Reignier, M Weiss, PG Dartevelle and P Herve
Centre Chirurgical Marie Lannelongue, Universite Paris Sud, Le Plessis Robinson, France.

Using isolated rat lungs, we compared prevention of ischemia- reperfusion injury provided by flushing the lungs with modified Euro- Collins solution (EC), University of Wisconsin solution (UW), low- potassium-dextran solution (LPD), or Wallwork solution (WA). After 4 hours' and 6 hours' cold ischemia, reperfusion injury was assessed on the basis of changes in filtration coefficients (Kfc) and pressure-flow curves, characterized by the slope of the curves (incremental resistance) and the extrapolation of this slope to zero flow (pulmonary pressure intercept [Ppi]). After 4 hours, Kfc and Ppi were higher with EC than with UW, LPD, and WA, and the incremental resistance was higher with EC and UW. After 6 hours, Kfc and incremental resistance Ppi were higher with LPD than with WA. Because ischemia-reperfusion injury is associated with decreased endothelial synthesis of prostacyclin and nitric oxide, we tested whether the addition of prostacyclin or the nitric oxide precursor L-arginine to WA would improve preservation. The Kfc and Ppi were lower with both treatments. In conclusion, ischemia- reperfusion injury was best prevented by using WA. The favorable effect of prostacyclin or L-arginine emphasizes the role played by endothelial dysfunction in ischemia-reperfusion injury.

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