| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1998;65:1420-1425
© 1998 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, University of Berne, Berne, Switzerland
b Memorial Sloan Kettering Cancer Center, New York, New York, USA
Accepted for publication December 8, 1997.
Address reprint requests to Dr Furrer, Thoracic and Vascular Surgery, Kantonsspital, CH-7000 Chur, Switzerland
e-mail: (markus.furrer{at}ksc.chur.ch)
Background. Cytostatic isolated lung perfusion has been advocated for treating pulmonary metastasis of soft tissue sarcoma. Different techniques of isolated lung perfusion have been developed.
Methods. Isolated lung perfusion with and without doxorubicin was performed on white pigs during 15 minutes either by a single-pass system (n = 7) or by a recirculating-blood perfusion system (n = 7). Three animals with endovenous drug application served as controls. Leakage was assessed using isotopic tracers. Perfusion-induced lung tissue injury was determined by postperfusion chest radiographs, by angiotensin-converting enzyme-to-protein ratio in the plasma and in the bronchioalveolar lavage fluid, and by wet-to-dry weight ratio and histologic examination of lung biopsy specimens at 20 and 50 minutes. Doxorubicin concentration in lung tissue and plasma was compared between the three study groups.
Results. All isolated lung perfusion studies were successfully performed without significant systemic leakage (<0.6%). Wet-to-dry weight ratio was significantly lower after single-pass as compared with recirculating-blood perfusion and endovenous drug application at both time points (5.0 ± 1.1 and 5.3 ± 0.8 for single-pass versus 6.6 ± 1.1 and 6.9 ± 0.5 for recirculating-blood versus 6.6 ± 0.2 and 5.9 ± 0.7 for the control group, respectively; p < 0.05). Angiotensin-converting enzyme-to-protein plasma ratio in the single-pass group was significantly lower only at 20 minutes (6.3 ± 2.4 versus 9.3 ± 1.0 versus 9.7 ± 1.9, respectively; p < 0.05) but not at 50 minutes. Angiotensin-converting enzyme-to-protein ratio in bronchoalveolar lavage fluid, histology of lung biopsy specimens, and chest radiographs did not differ significantly between the three groups. Doxorubicin lung tissue concentration was not significantly different after single-pass (17.5 µg/g) and recirculating-blood perfusion (21.9 µg/g), but was significantly higher than after endovenous drug application (3.0 µg/g; p < 0.01).
Conclusions. Both isolated lung perfusion techniques resulted in a sixfold to sevenfold higher doxorubicin lung tissue concentration than after endovenous application. Isolated lung perfusion-induced lung injury was similar for both techniques, but recirculating-blood perfusion appeared to result in more acute lung injury and was technically more demanding than single-pass perfusion.
This article has been cited by other articles:
|
|
 |
|
  C. Cheng, A. Haouala, T. Krueger, F. Mithieux, J. Y. Perentes, S. Peters, L. A. Decosterd, and H.-B. Ris Drug uptake in a rodent sarcoma model after intravenous injection or isolated lung perfusion of free/liposomal doxorubicin Interactive CardioVascular and Thoracic Surgery, June 1, 2009; 8(6): 635 - 638. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Yan, C. Cheng, A. Haouala, T. Krueger, J.-P. Ballini, S. Peters, L. A. Decosterd, I. Letovanec, H.-B. Ris, and S. Andrejevic-Blant Distribution of Free and Liposomal Doxorubicin After Isolated Lung Perfusion in a Sarcoma Model Ann. Thorac. Surg., April 1, 2008; 85(4): 1225 - 1232. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Krueger, A. Kuemmerle, S. Andrejevic-Blant, H. Yan, Y. Pan, J.-P. Ballini, W. Klepetko, L. A. Decosterd, R. Stupp, and H.-B. Ris Antegrade Versus Retrograde Isolated Lung Perfusion: Doxorubicin Uptake and Distribution in a Sarcoma Model Ann. Thorac. Surg., December 1, 2006; 82(6): 2024 - 2030. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Krueger, A. Kuemmerle, M. Kosinski, A. Denys, L. Magnusson, R. Stupp, A. B. Delaloye, W. Klepetko, L. Decosterd, H.-B. Ris, et al. Cytostatic lung perfusion results in heterogeneous spatial regional blood flow and drug distribution: Evaluation of different cytostatic lung perfusion techniques in a porcine model. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 304 - 311. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. F.W. Franke, T. Wittwer, M. Lessel, K. Liebing, M. Albert, V. Becker, H. Schubert, and T. Wahlers Evaluation of isolated lung perfusion as neoadjuvant therapy of lung metastases using a novel in vivo pig model: I. Influence of perfusion pressure and hyperthermia on functional and morphological lung integrity Eur. J. Cardiothorac. Surg., October 1, 2004; 26(4): 792 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. P. Van Putte, J. M. H. Hendriks, S. Romijn, B. Pauwels, G. De Boeck, G. Guetens, E. De Bruijn, and P. E. Y. Van Schil Pharmacokinetics after pulmonary artery perfusion with gemcitabine Ann. Thorac. Surg., October 1, 2003; 76(4): 1036 - 1040. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Furrer, D. Lardinois, W. Thormann, H.-J. Altermatt, D. Betticher, J. Triller, D. Mettler, U. Althaus, M. E. Burt, and H.-B. Ris Cytostatic Lung Perfusion by Use of an Endovascular Blood Flow Occlusion Technique Ann. Thorac. Surg., June 1, 1998; 65(6): 1523 - 1528. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
