Lung Transplantation by Continuous Perfusion in an Experimental Auto-Transplant Animal Model

Introduction

The optimization of the method and quality of pulmonary preservation has been the aim of many experimental studies. Intracellular solutions are no longer used, as they cause permanent depolarization of the smooth vasal muscle owing slow channels opening for calcium and vasoconstriction, and an increase in the ‘no-reflow’ phenomenon. These effects can be traced to the high concentration of K⁺ [1] [2]. Ionic extracellular solutions are used to reduce ichaemic/reperfusion damage [1] [3] [4], with and without the scavengers and/or platelet-activating factor antagonists. The sequestration of leukocytes and platelets leading to plugging, endothelial activation, and the production of free radicals is the basis of ischemic/reperfusion damage. Massad et al. [2] have shown how flushing of the pulmonary artery at an infusion pressure of 15 mm Hg reduces the sequestration of polymorphonucleates with respect to topical cooling. Binns et al. [5] reported improved pulmonary function after 18 hours of cold ischemia by administration of Ulinastatin (neutrophil endopeptidase inhibitor). Leukocyte infiltration depends on the quality of pulmonary preservation.

We decided to examine the physiological and histopathological aspects of lung protection when the cold flushing technique was used along with continual perfusion of the organ during cold storage.

References

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