Beneficial effects of leukocyte-depleted blood and low-potassium dextran solutions on microvascular permeability in preserved porcine lung.


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Article: article from journal or magazin.
Beneficial effects of leukocyte-depleted blood and low-potassium dextran solutions on microvascular permeability in preserved porcine lung.
American Journal of Respiratory and Critical Care Medicine
Schneuwly O.D., Licker M., Pastor C.M., Schweizer A., Slosman D.O., Kapanci Y., Nicod L.P., Robert J., Spiliopoulos A., Morel D.R.
1073-449X[print], 1073-449X[linking]
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Modified Euro-Collins (EC) solution, a crystalloid intracellular-type solution, has been commonly used for pulmonary preservation. Several experimental studies have shown the advantages of using extracellular colloid-based solutions. The aim of this study was to compare the quality of preservation of two extracellular colloid solutions, leukocyte-depleted blood (BL) and low-potassium dextran (LPD) solutions, with that of EC solution. Lungs of 22 domestic pigs were flushed and preserved with EC (n = 8), BL (n = 7), or LPD (n = 7) solution. After harvesting, one of the lungs was reperfused immediately in an ex vivo circuit (control lungs), whereas the contralateral lung was reperfused after 8 h of cold (4 degrees C) storage (preserved lungs). Besides the lung function parameters (gas exchange, pulmonary hemodynamics and mechanics), the permeability of the endothelial-epithelial barrier was assessed by determining the transferrin leak index (TLI) using a double radioisotopic method, by measuring the alveolar/arterial protein concentration ratio, and by analyzing histopathologic changes. The functional quality (oxygenation, airway resistance, dynamic compliance [CL, dyn]) of both BL and LPD lungs was slightly but significantly superior to that of EC lungs. However, pulmonary vascular resistance was lower in BL-preserved than in EC- or LPD-preserved lungs. The TLI was increased in EC control and preserved lungs, whereas it was low in BL and LPD control lungs and did not increase after preservation. The alveolar/arterial protein concentration ratio was not different between control groups, but was increased fourfold in EC-preserved compared with BL- or LPD-preserved lungs. Finally, EC-preserved lungs presented a weight gain about twice that of BL- and LPD-preserved lungs. Morphologic analysis confirmed these results, because in the EC-preserved lungs, rupture of alveolar septa and severe alveolar edema and hemorrhage were observed, whereas BL- and LPD-preserved lungs showed a relatively well-preserved structure. The results demonstrate that both BL and LPD flush solutions preserve the endothelial-epithelial barrier better than does EC solution. Although the quality of preservation is similar, pulmonary vascular resistance is higher in LPD-preserved than in BL-preserved lungs.
Animals, Blood, Capillary Permeability/drug effects, Capillary Permeability/physiology, Dextrans/pharmacology, Female, Hypertonic Solutions/pharmacology, Lung/drug effects, Lung/pathology, Lung Compliance/physiology, Lung Transplantation/pathology, Lung Transplantation/physiology, Lung Volume Measurements, Lymphocyte Depletion, Male, Organ Preservation, Organ Preservation Solutions/pharmacology, Oxygen/blood, Potassium/pharmacology, Reperfusion Injury/pathology, Reperfusion Injury/physiopathology, Respiratory Mechanics/physiology, Swine
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19/02/2010 19:51
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20/08/2019 15:28
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