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Ann Thorac Surg 1995;60:646-650
© 1995 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

L-Arginine and Pentoxifylline Attenuate Endothelial Dysfunction After Lung Reperfusion Injury in the Rabbit

Laboratoire de Chirurgie Expérimentale and Centre National de Recherche Scientifique, Unité de Recherche Associée 1159, Centre Chirurgical Marie Lannelongue, Paris-Sud University, Le Plessis Robinson, France

Accepted for publication April 15, 1995.

Background. Among the factors involved in the early complications of lung transplantation is the ischemia-reperfusion syndrome related to a warm reperfusion in ischemic lungs.

Methods. Using an isolated rabbit lung preparation perfused with whole blood, we studied the effects of cold ischemia followed by a warm reperfusion on pulmonary vascular responses to reproduce experimentally the conditions encountered during lung transplantation.

Results. Pulmonary vascular responses to acetylcholine were rapidly altered by warm ischemia (relaxation of 7% versus 60% in controls). Conversely, relaxation was maintained even after a prolonged cold ischemic storage (maximal relaxation of 57% at 48 hours). Warm reperfusion in ischemic lungs induced major alteration of endothelium-dependent relaxation (maximal relaxation of 13% at 4 hours). The addition of L-arginine or pentoxifylline during reperfusion prevented the pulmonary endothelial alteration resulting from warm reperfusion.

Conclusion. These data suggest that treatments aimed at maintaining intact functional endothelium reduce ischemia-reperfusion injury in transplanted lungs.

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