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Thorac Cardiovasc Surg 2004; 52(3): 174-179
DOI: 10.1055/s-2004-817977
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Warm or Cold Ischemia in Animal Models of Lung Ischemia-Reperfusion Injury: Is There a Difference?

G. Warnecke1 , S. P. Sommer1 , B. Gohrbandt1 , S. Fischer1 , J. M. Hohlfeld2 , J. Niedermeyer2 , A. Haverich1 , M. Strüber1
  • 1Hannover Thoracic Transplant Program, Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
  • 2Hannover Thoracic Transplant Program, Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
Further Information

Publication History

Received November 19, 2003

Publication Date:
11 June 2004 (online)

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Abstract

Objective: Experiments were designed to compare large animal models for lung ischemia-reperfusion injury using either 90 minutes' warm or 24 hours' cold ischemia. Methods: In 6 pigs, the left lung was perfused in situ with cold LPD solution. Reperfusion was started after 90 min of warm ischemia. The left lung of 6 donor pigs was perfused with LPD solution and the lung transplanted after 24 hours of cold storage into 6 recipient pigs. In both groups the right pulmonary artery and main bronchus were clamped after reperfusion of the left lung. Bronchoalveolar lavage (BAL) was obtained before ischemia and after 2 h of reperfusion. Hemodynamic and respiratory parameters were monitored. Surfactant activity was determined from the BAL in a pulsating bubble surfactometer. Results: Moderate lung injury was evident after reperfusion, but without any significant differences between groups. Surfactant composition and function were mildly impaired after reperfusion in both groups. Conclusions: Our results suggest that short periods of warm ischemia might be accepted as an accelerated model for ischemia-reperfusion injury of the lung after cold storage.

Key words

Ischemia-reperfusion injury - lung transplantation - animal model - LPD solution - warm ischemia

References

  • 1 King R C, Binns O AR, Rodriguez F. et al . Reperfusion injury significantly impacts clinical outcome after pulmonary transplantation.  Ann Thorac Surg. 2000;  69 1681-1685
    CrossrefPubMedGoogle Scholar
  • 2 Trulock E. Lung transplantation.  Am J Respir Crit Care Med. 1997;  155 789-818
    CrossrefPubMedGoogle Scholar
  • 3 Strüber M, Harringer W, Ernst M. et al . Inhaled nitric oxide as a prophylactic treatment against reperfusion injury of the lung.  Thorac Cardiovasc Surg. 1999;  47 179-182
    PubMedGoogle Scholar
  • 4 Hohlfeld J M, Strüber M, Ahlf K. et al . Exogenous surfactant improves survival and surfactant function in ischemia-reperfusion injury in minipigs.  Eur Respir J. 1999;  13 1037-1043
    CrossrefPubMedGoogle Scholar
  • 5 Strüber M, Hohlfeld J M, Fraund S, Kim P, Warnecke G, Haverich A. Low-potassium dextran solution ameliorates reperfusion injury of the lung and protects surfactant function.  J Thorac Cardiovasc Surg. 2000;  120 566-572
    CrossrefPubMedGoogle Scholar
  • 6 Warnecke G, Strüber M, Fraund S, Hohlfeld J M, Haverich A. Combined exogenous surfactant and inhaled nitric oxide therapy for lung ischemia-reperfusion injury in minipigs.  Transplantation. 2001;  71 1238-1244
    PubMedGoogle Scholar
  • 7 Strüber M, Hohlfeld J M, Kofidis T. et al . Surfactant function in lung transplantation after 24 hour ischemia - advantage of retrograde flush perfusion for preservation.  J Thorac Cardiovasc Surg. 2002;  123 98-103
    CrossrefPubMedGoogle Scholar
  • 8 Bartlett G R. Phosphorus assay in column chromatography.  J Biol Chem. 1959;  234 466-468
    PubMedGoogle Scholar
  • 9 Bligh E G, Dyer W J. A rapid method of total lipid extraction and purification.  Can J Biochem Physiol. 1959;  37 911-917
    CrossrefPubMedGoogle Scholar
  • 10 Enhorning G. Pulsating bubble technique for evaluating pulmonary surfactant.  J Appl Physiol. 1977;  43 198-203
    PubMedGoogle Scholar
  • 11 Maccherini M, Keshavjee S H, Slutsky A S, Patterson G A, Edelson J D. The effect of low-potassium dextran versus Euro-Collins solution for preservation of isolated type II pneumocytes.  Transplantation. 1991;  52 621-626
    PubMedGoogle Scholar
  • 12 Steen S, Kimblad P O, Sjöberg T, Lindberg L, Ingemansson R, Massa G. Safe lung preservation for twenty-four hours with Perfadex.  Ann Thorac Surg. 1994;  57 450-457
    CrossrefPubMedGoogle Scholar
  • 13 Ingemansson R, Massa G, Pandita R K, Sjöberg T, Steen S. Perfadex is superior to Euro-Collins solution regarding 24 hour preservation of vascular function.  Ann Thorac Surg. 1995;  60 1210-1214
    CrossrefPubMedGoogle Scholar
  • 14 Strüber M, Wilhelmi M, Harringer W. et al . Flush perfusion with low potassium dextran solution improves early graft function in clinical lung transplantation.  Eur J Cardiothorac Surg. 2001;  19 190-194
    CrossrefPubMedGoogle Scholar
  • 15 Van Raemdonck D EM, Jannis N CP, De Leyn P RJ, Flameng W J, Lerut T E. Warm ischemic tolerance in collapsed pulmonary grafts is limited to 1 hour.  Ann Surg. 1998;  228 788-796
    CrossrefPubMedGoogle Scholar
  • 16 Novick R J, Gehman K E, Ali I S, Lee J. Lung preservation: the importance of endothelial and alveolar type II cell integrity.  Ann Thorac Surg. 1996;  62 302-314
    CrossrefPubMedGoogle Scholar
  • 17 Ware L B, Matthay M A. The acute respiratory distress syndrome.  NEJM. 2000;  342 1334-1349
    CrossrefPubMedGoogle Scholar

PD Dr. Martin Strüber

Department of Thoracic and Cardiovascular Surgery
Hannover Medical School

Carl-Neuberg-Straße 1

30623 Hannover

Germany

Phone: + 495115326588

Fax: + 49 51 15 32 84 46

Email: strueber@thg.mh-hannover.de

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