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The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 83-89, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JD Puskas, PF Cardoso, E Mayer, S Shi, AS Slutsky and GA Patterson
Improved techniques of pulmonary preservation would help alleviate the
critical shortage of donor organs in lung transplantation and would improve
early graft function. A previous study demonstrated that cold pulmonary
artery flush with low-potassium dextran solution was superior to
Euro-Collins solution in preservation of canine lung allografts stored for
12 hours when no pulmonary vasodilator was used before donor lung flush.
The present study was designed to determine whether donor pretreatment with
prostaglandin E1 would affect the superiority of low- potassium dextran as
a preservation solution. Prostaglandin E1 was infused (50 micrograms/min)
in 12 donor dogs until potent vasodilation was demonstrated. Low-pressure
pulmonary artery flush (50 ml/kg) with either Euro-Collins or low-potassium
dextran solution (n = 6 for each group) was performed at 4 degrees C in a
randomized, blinded fashion. Heart-lung blocks were extracted and stored at
4 degrees C for 18 hours before left lung allografting. Inflatable cuffs
were placed around each pulmonary artery, allowing independent study of the
native and transplanted lungs. All 12 recipient dogs survived the 3-day
assessment period. Lungs flushed and stored in Euro-Collins or
low-potassium dextran solution provided equivalent gas exchange function on
day 0 (arterial oxygen tension: Euro-Collins 289 +/- 105 mm Hg versus low-
potassium dextran 265 +/- 111 mm Hg; mean +/- standard error of the mean)
and on day 3 (Euro-Collins 516 +/- 45 mm Hg versus low-potassium dextran
354 +/- 77 mm Hg; p = 0.10). Mean pulmonary artery pressures in the
transplanted lung were not significantly different in the Euro- Collins and
low-potassium dextran groups on day 0 (21.4 +/- 2 mm Hg versus 33.7 +/- 5
mm Hg, respectively; p = 0.09) or on day 3 (20.2 +/- 2.7 mm Hg versus 24.2
+/- 5.1 mm Hg, respectively; p = 0.50). We conclude that there was no
advantage of low-potassium dextran over Euro- Collins as a flush solution
in this 18-hour canine single lung allograft model in which prostaglandin
E1 was administered before pulmonary artery flush.
ARTICLES
Equivalent eighteen-hour lung preservation with low-potassium dextran or Euro-Collins solution after prostaglandin E1 infusion
Department of Surgery, University of Toronto, Toronto General Hospital, Ontario, Canada.
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