HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Takahiro Oto Franklin Rosenfeldt Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Oto, T. Articles by Snell, G. I. Search for Related Content PubMed PubMed Citation Articles by Oto, T. Articles by Snell, G. I. Related Collections Lung - transplantation

Ann Thorac Surg 2006;82:1842-1848
© 2006 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

Early Outcomes Comparing Perfadex, Euro-Collins, and Papworth Solutions in Lung Transplantation

Heart and Lung Transplant Unit, The Alfred Hospital, Melbourne, Australia

Accepted for publication May 18, 2006.

^_* Address correspondence to Dr Snell, Department of Allergy, Immunology, and Respiratory Medicine, The Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia (Email: g.snell{at}alfred.org.au).

BACKGROUND: Despite improved surgical techniques and medical management, primary graft dysfunction (PGD) remains a major cause of early morbidity and mortality after lung transplantation. Different types of lung preservation solutions have been developed and applied to clinical use; however, the relative clinical efficacy of these solutions to prevent PGD remains controversial. This study aimed to investigate the effect of the three solutions most commonly used (Perfadex [Vitrolife, Göteborg, Sweden], Papworth, and Euro-Collins [Baxter Healthcare, Old Toongabbie NSW, Australia]) on posttransplant outcomes.

METHODS: Early outcomes from 157 consecutive lung transplants (113 bilateral and 44 single) performed at The Alfred Hospital were compared across three preservation solutions.

RESULTS: Posttransplant oxygenation (p = 0.57), pulmonary vascular resistance (p = 0.34), intubation hours (p = 0.66), intensive care unit days (p = 0.34), severe PGD (grade 3) (p = 0.70), 30-day mortality (p = 0.87), and 3-month % predicted forced expiratory volume in 1 second (p = 0.58) were not statistically different; however, Perfadex trended toward superiority among the three solutions. After adjustment of donor, recipient, and operative factors in multivariate analysis, Perfadex was significantly associated with the prevention of moderate to severe PGD (grade 2 to 3) at 48 hours posttransplant (odds ratio = 0.26 [0.10 to 0.72], p < 0.01) compared with Papworth (odds ratio = 0.75 [0.32 to 1.75], p = 0.51) and Euro-Collins (reference) solutions.

CONCLUSIONS: Although any advantageous effects of Perfadex on early posttransplant outcomes were generally subtle and statistically nonsignificant, Perfadex prevented moderate to severe PGD. Switching preservation solution from Euro-Collins (or Papworth) to Perfadex would appear to usefully contribute to a strategy to reduce PGD in lung transplantation.

This article has been cited by other articles:

				W. Bartosik, J. J. Egan, A. Soo, K. F. Remund, L. Nolke, J. F. McCarthy, and A. E. Wood A review of the lung transplantation programme in Ireland 2005-2007 Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 807 - 811. [Abstract] [Full Text] [PDF]

				D. R. McIlroy, D. V. Pilcher, and G. I. Snell Does anaesthetic management affect early outcomes after lung transplant? An exploratory analysis Br. J. Anaesth., April 1, 2009; 102(4): 506 - 514. [Abstract] [Full Text] [PDF]

				G. Ailawadi, C. L. Lau, P. W. Smith, B. R. Swenson, S. A. Hennessy, C. J. Kuhn, L. M. Fedoruk, B. D. Kozower, I. L. Kron, and D. R. Jones Does reperfusion injury still cause significant mortality after lung transplantation? J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 688 - 694. [Abstract] [Full Text] [PDF]

				M. Wu, Q. Yang, A. P.C. Yim, M. J. Underwood, and G.-W. He Cellular electrophysiologic and mechanical evidence of superior vascular protection in pulmonary microcirculation by Perfadex compared with Celsior. J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 492 - 498. [Abstract] [Full Text] [PDF]

				J. C. Lee and J. D. Christie Primary Graft Dysfunction Proceedings of the ATS, January 15, 2009; 6(1): 39 - 46. [Abstract] [Full Text] [PDF]

				P. A. Corris and J. D. Christie Update in Transplantation 2006 Am. J. Respir. Crit. Care Med., March 1, 2007; 175(5): 432 - 435. [Full Text] [PDF]

				T. Oto, B. J. Levvey, H. Whitford, A. P. Griffiths, T. Kotsimbos, T. J. Williams, and G. I. Snell Feasibility and Utility of a Lung Donor Score: Correlation With Early Post-Transplant Outcomes Ann. Thorac. Surg., January 1, 2007; 83(1): 257 - 263. [Abstract] [Full Text] [PDF]