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Ann Thorac Surg 1996;61:973-976
© 1996 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Low-Potassium Solution for Lung Preservation in the Setting of High-Flow Reperfusion

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia

Accepted for publication November 13, 1995.

Background. We previously demonstrated that standard preservation using Euro-Collins solution impairs lung function in the setting of high-flow reperfusion because of potassium-induced vasoconstriction. Preservation strategies for single-lung transplantation are an important factor in patients with pulmonary hypertension. This study investigates the hypothesis that low-potassium preservation solution will improve function of lungs subjected to high-flow reperfusion.

Methods. Twenty-one New Zealand white rabbit lungs were harvested and studied on an isolated, blood-perfused model of lung function after 4 hours of cold ischemia at 4°C. Control lungs were preserved with 50 mL/kg of cold saline solution flush (group I). Experimental lungs were preserved with low-potassium solution (group II) or Euro-Collins solution (group III) at similar temperatures and volumes.

Results. The pulmonary arteriovenous oxygen gradient at the end of the 30-minute high-flow reperfusion period was significantly higher in group II compared with group III (121.3 ± 19.2 mm Hg versus 31.1 ± 4.2 mm Hg; p < 0.001). The pulmonary vascular resistance was significantly lower in group II than in group III (46.3 ± 1.8 x 10³ dynes•s•cm^-5 versus 79.8 ± 8.4 x 10³ dynes•s•cm^-5; p < 0.01). The percent decrease in dynamic airway compliance in group III was significantly greater than in groups I and II (-51.0% ± 13.3% versus -10.2% ± 3.4% and -11.2% ± 2.8%, respectively; p < 0.001). Similarly, the wet to dry ratio of the lungs in group III was significantly greater than in groups I and II (13.9 ± 2.3 versus 5.9 ± 0.2 and 6.0 ± 0.4, respectively; p < 0.001).

Conclusions. These data demonstrate that a low-potassium preservation solution yields improved lung function after high-flow reperfusion in an ex vivo rabbit lung model. Lung preservation should be aimed at the clinical setting.

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