Experimental lung preservation with perfadex: effect of the no-donor nitroglycerin on postischemic outcome
| Autor: | Johannes M. Albes, Thorsten Wittwer, Thomas Pech, Antonia Fehrenbach, Thorsten Wahlers, Joachim Richter, Ulrich F.W. Franke |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Pulmonary Circulation medicine.medical_treatment Hypertonic Solutions Ischemia In Vitro Techniques 030204 cardiovascular system & hematology Nitric oxide Rats Sprague-Dawley Nitroglycerin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Animals Lung transplantation Citrates Lung business.industry Oxygenation Pulmonary edema medicine.disease Rats 3. Good health Oxygen medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Anesthesia Reperfusion Vascular resistance Vascular Resistance Surgery Tissue Preservation Cardiology and Cardiovascular Medicine business Perfusion Lung Transplantation |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 125:1208-1216 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(02)73244-3 |
| Popis: | ObjectiveOptimal preservation of postischemic graft function is essential in lung transplantation. Antegrade flush perfusion with modified Euro-Collins solution represents the standard technique worldwide. However, growing evidence suggests the superiority of extracellular-type Perfadex solution (Vitrolife AB, Gothenburg, Germany) over Euro-Collins solution. During ischemia and reperfusion, endogenous pulmonary nitric oxide synthesis is decreased, and therefore therapeutic stimulation of the nitric oxide pathway might be beneficial in ameliorating ischemia-reperfusion damage. However, research mainly focuses on nitric oxide supplementation of intracellular solutions, and no studies exist in which the effect of nitroglycerin on Perfadex preservation quality is evaluated.MethodsEight rat lungs each were preserved with Perfadex solution with or without nitroglycerin (0.1 mg/mL) and compared with low-potassium Euro-Collins solution. Postischemic lungs were reventilated and reperfused, and oxygenation capacity, pulmonary vascular resistance, and peak inspiratory pressures were monitored continuously. Stereological analysis was used for evaluation of pulmonary edema and assessment of the vasculature. Statistics were performed by using different analysis of variance models.ResultsThe oxygenation capacity of the Perfadex-preserved groups was higher compared with that of the low-potassium Euro-Collins solution group (P < .03). By using nitroglycerin, flush-perfusion time was reduced, and Perfadex solution with nitroglycerin–protected lungs showed superior oxygenation capacity compared with that seen in Perfadex solution–protected organs (P < .01). Furthermore, pulmonary vascular resistance and peak inspiratory pressures were improved in the nitroglycerin group (P < .01). Stereology revealed comparable intrapulmonary edema between groups and a trend toward less vasoconstricted vasculature in Perfadex with nitroglycerin–protected lungs.ConclusionsPerfadex solution provides superior lung preservation in terms of postischemic oxygenation capacity than Euro-Collins solution. Supplementation of the nitric oxide pathway by nitroglycerin further enhances functional outcome of Perfadex-preserved organs and might be an easily applicable tool in clinical lung transplantation. |
| Databáze: | OpenAIRE |
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