Evaluation of the initial lung flushing with oxygenated blood on the adequacy of lung preservation.

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Background. Previous studies have shown that availability of oxygen during lung preservation to maintain aerobic metabolism may be essential for the optimum viability of preserved lung tissue. The purpose of this study was to evaluate lung preservation with oxygenated blood for an optimum oxygen delivery to the lung graft in a rabbit model. Materials and methods. Eighteen excised rabbit lungs were flushed and stored for 18 hours at 10ﾟC with one of following ; Euro-Collins solution (EC ; n=6), oxygenated homologous blood (OB ; n=6), or low-potassium dextran solution (LPD ; n=6). Poststorage lung functions were evaluated with isolated, blood-perfused lung model for 10 minutes. For the assessment of neutrophil recruitment and endothelial cells injury in the lung graft, thrombomodulin, E-selectin, and endothelin were measured by the ELISA.Results. The mean oxygen tensions at 10 minutes after the onset of reperfusion for the EC,OB,LPD groups were 47.0(]SY.+-。[)2.8<@D1**@>D1,76.9(]SY.+-。[)1 … More 3.1,96.2(]SY.+-。[)10.9 mmHg, respectively (<@D1**@>D1p<0.05 vs OB,LPD). Pulmonary artery pressure during the reperfusion period in the EC (35.8(]SY.+-。[)4.4 mmHg at 10 min) was higher than that in the OB and LPD groups (29.8(]SY.+-。[)4.3,22.4(]SY.+-。[)2.2 mmHg, respectively). However, E-selectin in the reperfused blood in the OB (5.04(]SY.+-。[)0.24 ng/ml) was significantly elevated than in other groups (EC ; 3.56(]SY.+-。[)0.54, LPD ; 2.92(]SY.+-。[)0.35 ng/ml, p<0.05), which indicated an enhanced neutrophil recruitment in the OB group. Comparisons of thrombo-modulin and endothelin between the three groups did not reach a statistical significance. Conclusions. We conclude that oxygenated blood may enhance lung preservation as compared to Euro-Collins solution, probably through its enriched oxygen delivery during storage and extracellular composition. However, the availability does not exceed LPD solution because of augmented neutrophil recruitment which may activate neutrophil-endothelial interacrions. Less