Pentoxifylline is as effective as leukocyte depletion for modulating pulmonary reperfusion injury.

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.

• 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)

Chemical References

• Malondialdehyde
• Leukocyte Elastase
• Pentoxifylline

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