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Right arrow Lung - transplantation

J Thorac Cardiovasc Surg 2003;125:907-912
© 2003 The American Association for Thoracic Surgery

Cardiothoracic Transplantation

Long-term (72 hours) preservation of rat lungs

Rafael Aguiló, MDa, Enric Serra, MDb, Bernat Togores, MDc, Andrés de la Peña, MDd, Carmen Santosd, Alvar G. N. Agustí, MDc

From the Serveis de Cirurgia Toràcica,a Anatomia Patológica,b Pneumologia,c and Unitat d'Investigació,d Hospital Universitari Son Dureta, Palma de Mallorca, Spain.

Supported in part by Fondo de Investigación Sanitaria (FIS 97/0914), Sociedad Española de Neumología y Cirugía Torácica (SEPAR) and ABEMAR.

Received for publication June 3, 2002. Accepted for publication Aug 6, 2002. Address for reprints: Alvar Agustí, MD, Hospital Universitari Son Dureta. Andrea Doria, 55. 07014 Palma de Mallorca, Spain (E-mail: aagusti{at}hsd.es).

Objective: We sought to investigate whether the addition of ethanol to a preservation solution (as an antifreeze agent) might allow a reduction of the storage temperature to 0°C without causing freezing damage and improve lung function after prolonged (72 hours) ischemia.
Methods: Lungs from Sprague-Dawley rats were ventilated and perfused ex vivo at 37°C for 60 minutes in the following experimental groups: (1) the no ischemia and reperfusion (no I-R) group (n = 7), in which lungs were studied immediately after harvesting; (2) the LPD24 (n = 7) and (3) LPD72 (n = 8) groups, in which, after harvesting, lungs were flushed and immersed in low-potassium dextran solution and stored deflated at 10°C for 24 and 72 hours, respectively, until reperfusion; and (4) the TEST72 group (n = 9), in which lungs were flushed and immersed in Krebs-Henseleit buffer with added ethanol (10 mL/L) after harvesting and stored deflated at 0°C for 72 hours until reperfusion.
Results: Compared with the no I-R group, the other 3 groups had worse lung function, higher lung water content, and evidence of cell injury at reperfusion (P < .01). However, lung function at reperfusion (assessed on the basis of either effluent PO2, peak airway pressure, or mean arterial pulmonary pressure) was better (P < .01) in the TEST72 group than in the LPD24 or LPD72 groups. Paradoxically, lung cell structure was better preserved in the LPD24 group than in the TEST72 group (or the LPD72 group).
Conclusions: In this experimental model of rat lung ischemia-reperfusion injury, a low preservation temperature (0°C) combined with the addition of ethanol to the preservation solution improves lung function at reperfusion after 72 hours of ischemia but fails to maintain lung cell structure.






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