Euro-Collins solution exacerbates lung injury in the setting of high- flow reperfusion

N. F. DeLima, O. A.R. Binns, S. A. Buchanan, M. C. Mauney, J. T. Cope, K. S. Shockey, C. G. Tribble, I. L. Kron

Research output: Contribution to journalArticlepeer-review

Abstract

Single-lung transplantation has been abandoned for the treatment of pulmonary hypertension by many centers because of overperfusion of the graft following implantation. Euro-Collins solution is currently used for lung preservation despite the vasoconstrictive effect of this intracellular-type solution. We hypothesized that high-flow reperfusion, alone or in combination with Euro-Collins-induced vasoconstriction, may cause lung dysfunction. Twenty-eight New Zealand White rabbit lungs were harvested and studied in an isolated, blood-perfused model of lung function after 4 hours of cold ischemia. Control lungs were preserved with 50 ml/kg cold saline solution flush and reperfused at either normal flow (60 ml/min) or high flow (120 ml/min). Experimental lungs were preserved with 50 ml/kg cold Euro-Collins solution and reperfused at normal or high flow rates. The arteriovenous oxygen gradient at the end of the 30-minute reperfusion period was significantly lower in the high-flow versus the low-flow experimental group (31.1 ± 4.2 vs 130.6 ± 41.6 mm Hg, p < 0.05). The pulmonary vascular resistance was increased in the high-flow groups and the experimental groups, with a statistically significant difference between low-flow experimental and control groups (64374.4 ± 5722.6 vs 37041.5 ± 2110.9 dynes · sec · cm- 5 p < 0.001). The percentage decrease in dynamic airway compliance in the high-flow experimental group was markedly different from that in the high- flow control group (-51% ± 13.3% vs -10.15% ± 3.4%, p < 0.05). Similarly, the wet/dry ratio of the lungs in the high-flow experimental group (13.92 ± 2.32) was significantly greater than that in the low-flow experimental group (6.27 ± 0.19, p < 0.01) and than that in the high-flow control group (5.88 ± 0.23, p < 0.001). These data demonstrate that high-flow reperfusion and preservation with Euro-Collins solution are deleterious to lung function, both individually and in combination, in an ex vivo rabbit lung model. Lung preservation with Euro-Collins solution may not be optimal when high-flow reperfusion is anticipated, as in the setting of unilateral lung transplantation for pulmonary hypertension.

Original languageEnglish (US)
Pages (from-to)111-116
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume112
Issue number1
DOIs
StatePublished - 1996

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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