Abstract | OBJECTIVE: Previous studies have suggested the amelioration of lung reperfusion injury when initial reperfusion is undertaken with leukocyte-depleted blood. Pharmacologic agents, such as pentoxifylline, are also effective, but no previous studies have demonstrated which is superior. We investigated these agents in a porcine model of left single- lung transplantation. METHODS: Donor lungs were preserved with modified Euro-Collins solution for a mean ischemic time of 18.6 hours. Gas exchange, pulmonary vascular resistance, neutrophil elastase level, and free radical release (measured on the basis of malonaldehyde levels) were assessed over a 12-hour period. Group A (n = 5) was a control group with no interventions added. Group B was reperfused through an extracorporeal circuit incorporating a leukocyte-depleting filter for 30 minutes before conventional blood flow was restored. Group C was reperfused with the addition of intravenous pentoxifylline (2 mg x kg(-1) x h(-1)). RESULTS: Groups B and C were similar in terms of oxygenation, pulmonary vascular resistance, and free radical release. Group B displayed increased levels of neutrophil elastase. Both groups were superior with regard to these outcome measures compared with control group A. CONCLUSIONS:
Pentoxifylline, when administered to recipient animals, attenuates reperfusion injury to a degree similar to that seen with leukocyte-depleted reperfusion. This technique is simple, safe, and as effective as using a more complex extracorporeal circuit incorporating a leukocyte-depleting filter to ameliorate acute lung injury.
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Authors | Stephen C Clark, Jagan N Rao, Paul A Flecknell, John H Dark |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 126
Issue 6
Pg. 2052-7
(Dec 2003)
ISSN: 0022-5223 [Print] United States |
PMID | 14688725
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Malondialdehyde
- Leukocyte Elastase
- Pentoxifylline
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Topics |
- Animals
- Female
- Leukapheresis
- Leukocyte Elastase
(blood)
- Lung Transplantation
- Malondialdehyde
(blood)
- Pentoxifylline
(administration & dosage)
- Pulmonary Circulation
- Pulmonary Gas Exchange
- Reperfusion
(methods)
- Reperfusion Injury
(physiopathology, prevention & control)
- Swine
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