Combined use of prostacyclin and higher perfusate temperatures further enhances the superior lung preservation by Celsior solution in the isolated rat lung.

Abstract

BACKGROUND:

The poor tolerance of the lung to ischemia and reperfusion (IR) still represents one of the limitations in clinically successful lung transplantation. Modified Euro-Collins (EC) is routinely used in lung preservation, but alternative solutions have been developed for improvement of pulmonary preservation. Celsior is an extracellular solution that has significantly reduced the IR-induced pulmonary damage in animal studies. So far, no extensive experimental studies exist concerning the influence of Celsior on pulmonary gas exchange following IR.

METHODS:

In an extracorporeal rat lung model 10 lungs, each, were preserved with Celsior (CE) and Celsior/prostacyclin (CEPC, 6 microg/100 ml) at 4 degrees and 15 degrees C, each, and compared to low-potassium Euro-Collins (EC-40, 40 mmol/liter potassium). After 2 hours of ischemia lungs were reventilated and reperfused using a roller pump. Oxygenation in terms of oxygen partial tension in the left atrial effluent, pulmonary vascular resistance (PVR), peak inspiratory pressure, and wet/dry ratio were monitored for 50 minutes. Furthermore, edema formation was evaluated by light microscopy. Statistical analysis was performed using ANOVA models.

RESULTS:

Compared to the EC-40 group, oxygenation was increased and amount of edema was reduced in most Celsior-preserved organs (p<0.032) with exception of the CEPC group at 4 degrees C (p = 0.06). Additional application of prostacyclin did not have any significant effect on oxygenation in the Celsior group. However, after temperature elevation of the CEPC perfusate to 15 degrees C, a superior partial tension of oxygen was observed (p<0.023) in contrast to the 4 degrees C groups CE and CEPC. The lowest PVR was found in the CE 4 degrees C group (p<0.02).

CONCLUSIONS:

Celsior provides better lung preservation than EC-40 solution. Application of prostacyclin at higher perfusate temperatures results in additional functional improvement. In vivo experiments and ultrastructural analysis are warranted for further evaluation of Celsior in lung preservation.

• Authors: T Wittwer, T Wahlers, A Fehrenbach, J F Cornelius, S Elki, M Ochs, H Fehrenbach, J Albes, A Haverich, J Richter
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 18 Issue 7 Pg. 684-92 (Jul 1999) ISSN: 1053-2498 [Print] United States
• PMID: 10452345 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Celsior
• Disaccharides
• Electrolytes
• Euro-Collins' solution
• Glutamates
• Hypertonic Solutions
• Organ Preservation Solutions
• Mannitol
• Histidine
• Epoprostenol
• Glutathione
• Oxygen

Topics

• Animals
• Disaccharides (pharmacology)
• Electrolytes (pharmacology)
• Epoprostenol (pharmacology)
• Glutamates (pharmacology)
• Glutathione (pharmacology)
• Histidine (pharmacology)
• Hypertonic Solutions (pharmacology)
• Lung (anatomy & histology, drug effects, physiology)
• Male
• Mannitol (pharmacology)
• Organ Preservation (methods, statistics & numerical data)
• Organ Preservation Solutions (pharmacology)
• Oxygen (physiology)
• Partial Pressure
• Perfusion (methods, statistics & numerical data)
• Rats
• Rats, Sprague-Dawley
• Temperature